Hamdi S M, Almont T, Galinier P, Mieusset R, Thonneau P
EA 3694 Human Fertility Research Group, CHU de Toulouse, University of Toulouse, Toulouse, France.
Laboratory of Biochemistry and Hormonology, CHU de Toulouse, University of Toulouse, Toulouse, France.
Andrology. 2017 Jul;5(4):783-789. doi: 10.1111/andr.12373. Epub 2017 May 23.
In cryptorchid boys, failures in germ cell development have been clearly established. Some studies reported some abnormalities in Sertoli cells morphology but the results regarding their endocrine secretion remain controversial. To compare testicular hormone levels in young boys with and without cryptorchidism, we performed a cross-sectional hospital-based study. From surgery appointment records, we identified a case group of boys with unilateral or bilateral cryptorchidism and a control group undergoing dental care, minor osteoarticular or dermal surgery. Blood samples were withdrawn during the surgical procedure to perform testosterone, inhibin B and anti-müllerian hormone (AMH) immunoassays. We included 27 cryptorchid boys and 27 controls aged of 26.6 vs. 24.2 months, respectively (p = 0.172) far from the post-natal mini-puberty and the corresponding hormonal surges. Age-adjusted AMH and inhibin B levels were significantly lower in cryptorchid than in control boys (AMH: 87 ng/mL vs. 135 ng/mL; p = 0.009, inhibin B: 97 pg/mL vs. 133 pg/mL; p = 0.019, respectively). Moreover, AMH and inhibin B levels were significantly lower in the bilateral cryptorchid subgroup, being 50% lower than in the controls (p = 0.011 and 0.019, respectively) and while both hormones levels were independent in controls, they became strongly correlated in bilateral cryptorchid boys (R² = 0.75, p = 0.001). In addition, testosterone levels were still detectable in some boys, with significantly lower levels in cryptorchid group than in controls. Overall, 2-year-old cryptorchid patients presented a simultaneous and significant drop in AMH and inhibin B levels, suggesting a functional defect of Sertoli cells. This deficiency appeared more pronounced in bilateral cryptorchidism and thus, regarding the pivotal role of Sertoli cells in germ cell development, it may explain the compromised fertility found later in men born with such a malformation.
在隐睾症男孩中，生殖细胞发育失败已得到明确证实。一些研究报告了支持细胞形态存在一些异常，但关于其内分泌分泌的结果仍存在争议。为了比较有或无隐睾症的年轻男孩的睾丸激素水平，我们开展了一项基于医院的横断面研究。从手术预约记录中，我们确定了一组单侧或双侧隐睾症男孩作为病例组，以及一组接受牙科护理、小型骨关节或皮肤手术的对照组。在手术过程中采集血样，进行睾酮、抑制素B和抗苗勒管激素（AMH）免疫测定。我们纳入了27名隐睾症男孩和27名对照男孩，年龄分别为26.6个月和24.2个月（p = 0.172），远离出生后的小青春期及相应的激素激增期。经年龄调整后，隐睾症男孩的AMH和抑制素B水平显著低于对照男孩（AMH：87 ng/mL对135 ng/mL；p = 0.009，抑制素B：97 pg/mL对133 pg/mL；p = 0.019）。此外，双侧隐睾症亚组的AMH和抑制素B水平显著更低，比对照组低50%（分别为p = 0.011和0.019），虽然在对照组中两种激素水平相互独立，但在双侧隐睾症男孩中它们变得高度相关（R² = 0.75，p = 0.001）。此外，一些男孩仍可检测到睾酮水平，隐睾症组的水平显著低于对照组。总体而言，2岁的隐睾症患者AMH和抑制素B水平同时显著下降，提示支持细胞存在功能缺陷。这种缺陷在双侧隐睾症中更为明显，因此，鉴于支持细胞在生殖细胞发育中的关键作用，这可能解释了患有这种畸形的男性日后生育能力受损的原因。
