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男性中枢性性早熟:促性腺激素释放激素类似物治疗前后血清抗苗勒管激素和抑制素 B 水平。

Male Central Precocious Puberty: Serum Profile of Anti-Müllerian Hormone and Inhibin B before, during, and after Treatment with GnRH Analogue.

机构信息

Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE), CONICET-FEI-División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina.

出版信息

Int J Endocrinol. 2013;2013:823064. doi: 10.1155/2013/823064. Epub 2013 Nov 12.

Abstract

We aimed to describe the functional changes of Sertoli cells, based on the measurement of serum anti-Müllerian hormone (AMH) and inhibin B during treatment with GnRHa and after its withdrawal in boys with central precocious puberty. Six boys aged 0.8 to 5.5 yr were included. AMH was low at diagnosis in patients >1 yr but within the normal range in younger patients. AMH increased to normal prepubertal levels during treatment. After GnRHa withdrawal, AMH declined concomitantly with the rise in serum testosterone. At diagnosis, inhibin B was elevated and decreased throughout therapy, remaining in the upper normal prepubertal range. In patients with testicular volume above 4 mL AMH remained higher in spite of suppressed FSH. After treatment withdrawal, inhibin B rose towards normal pubertal levels. In conclusion, AMH did not decrease in patients <1 yr reflecting the lack of androgen receptor expression in Sertoli cells in early infancy. Serum inhibin B might result from the contribution of two sources: the mass of Sertoli cells and the stimulation exerted by FSH. Sertoli cell markers might provide additional tools for the diagnosis and treatment followup of boys with central precocious puberty.

摘要

我们旨在描述 Sertoli 细胞的功能变化,基于抗缪勒管激素(AMH)和抑制素 B 的血清测量,在 GnRH 治疗期间和停药后在中枢性性早熟的男孩中。纳入了 6 名年龄在 0.8 至 5.5 岁的男孩。在诊断时,年龄大于 1 岁的患者的 AMH 较低,但在年龄较小的患者中处于正常范围内。AMH 在治疗期间增加到正常的青春期前水平。GnRHa 停药后,AMH 随着血清睾酮的升高而下降。在诊断时,抑制素 B 升高并在整个治疗过程中下降,仍处于青春期前正常范围的上限。在睾丸体积大于 4ml 的患者中,尽管 FSH 受到抑制,AMH 仍保持较高水平。停药后,抑制素 B 升高至正常青春期水平。总之,在 1 岁以下的患者中,AMH 没有下降,这反映了在婴儿早期雄激素受体在 Sertoli 细胞中缺乏表达。血清抑制素 B 可能来自两个来源的贡献:Sertoli 细胞的质量和 FSH 的刺激。Sertoli 细胞标志物可能为中枢性性早熟男孩的诊断和治疗随访提供额外的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8240/3845850/9c09e50bd2d3/IJE2013-823064.001.jpg

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