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早期雄激素治疗对47,XXY男孩行为表型的积极影响。

Positive effects of early androgen therapy on the behavioral phenotype of boys with 47,XXY.

作者信息

Samango-Sprouse Carole, Stapleton Emily J, Lawson Patrick, Mitchell Francie, Sadeghin Teresa, Powell Sherida, Gropman Andrea L

出版信息

Am J Med Genet C Semin Med Genet. 2015 Jun;169(2):150-7. doi: 10.1002/ajmg.c.31437. Epub 2015 May 1.

Abstract

47, XXY occurs in up to 1 in 650 male births and is associated with androgen deficiency, neurodevelopmental delays, and atypical social-behaviors. Previously, we showed that young boys with 47, XXY who received early hormonal therapy (EHT) had significantly improved neurodevelopment. The objective of this follow-up study was to examine the effects of EHT on social behavior in boys with 47, XXY. The study consisted of boys prenatally diagnosed with 47, XXY who were referred for evaluations. Twenty-nine boys received three injections of 25 mg testosterone enanthate and 57 controls did not receive EHT. Behavioral functioning was assessed using the Behavior Rating Inventory of Executive Function, Social Responsiveness Scale, 2nd Ed., and the Child Behavior Checklist for Ages 6-18. The hypothesis that EHT may affect behavior was formulated prior to data collection. Questionnaire data was prospectively obtained and analyzed to test for significance between two groups. Significant differences were identified between group's scores over time in Social Communication (P=0.007), Social Cognition (P=0.006), and Total T-score (P=0.001) on the SRS-2; Initiation (P=0.05) on the BRIEF; and Externalizing Problems (P=0.024), Affective Problems (P=0.05), and Aggressive Behaviors (P=0.031) on the CBCL. This is the third study revealing positive effects of EHT on boys with XXY. There was a significant improvements associated with the 47, XXY genotype in boys who received EHT. Research is underway on the neurobiological mechanisms, and later developmental effects of EHT.

摘要

47, XXY在每650例男性出生中发生率高达1例,与雄激素缺乏、神经发育迟缓及非典型社会行为有关。此前,我们发现接受早期激素治疗(EHT)的47, XXY男孩神经发育有显著改善。这项随访研究的目的是检验EHT对47, XXY男孩社会行为的影响。该研究包括产前诊断为47, XXY并被转诊进行评估的男孩。29名男孩接受了三次25毫克庚酸睾酮注射,57名对照未接受EHT。使用执行功能行为评定量表、第二版社会反应量表和6 - 18岁儿童行为清单评估行为功能。EHT可能影响行为这一假设在数据收集之前就已提出。前瞻性地获取并分析问卷数据以检验两组之间的显著性。在SRS - 2的社会沟通(P = 0.007)、社会认知(P = 0.006)和总T分数(P = 0.001);BRIEF的启动(P = 0.05);以及CBCL的外化问题(P = 0.024)、情感问题(P = 0.05)和攻击行为(P = 0.031)方面,两组得分随时间存在显著差异。这是第三项揭示EHT对XXY男孩有积极影响的研究。接受EHT的男孩中与47, XXY基因型相关有显著改善。关于EHT的神经生物学机制及后期发育影响的研究正在进行中。

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