Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
Endocrine. 2018 Nov;62(2):274-280. doi: 10.1007/s12020-018-1670-9. Epub 2018 Jul 7.
The assessment of testicular function is not currently performed in childhood. The aim of this review was to address the usefulness of serum Anti-Müllerian Hormone (AMH), inhibin B, and testicular volume (TV) evaluation in children.
Serum AMH and inhibin B levels reflect Sertoli cells (SCs) health and number, SCs maturation degree and their exposure to FSH and to intra-tubular testosterone (T). These hormones might be helpful in discriminating between congenital central hypogonadism (cHH) and constitutional delay in growth and puberty (CDGP) and in case of clinical suspicious of precocious puberty. Furthermore, low AMH and/or inhibin B levels have been observed in children with primary testicular disorders, suggesting the existence of SC dysfunction. TV also provides useful information on testicular health. Recently, a medical calculator, requiring testis length and the stage of genital development, has been developed to easily derive TV.
The evidence supports the usefulness of AMH, inhibin B and TV evaluation for the early diagnosis of puberty disorders and primary testicular damage. We suggest the measurement of TV by using the medical calculator in all children and to reserve AMH and inhibin B measurements to those cases of no testicular growth, clinical suspicious of puberty disorders or in children at risk for spermatogenesis damage. This work-up might allow the early detection of testicular tubular damage which, in turn, may be useful to prevent the oncoming male infertility in adulthood.
目前在儿童时期不进行睾丸功能评估。本综述旨在探讨血清抗缪勒管激素（AMH）、抑制素 B 和睾丸体积（TV）评估在儿童中的应用价值。
血清 AMH 和抑制素 B 水平反映了支持细胞（SCs）的健康和数量、SCs 的成熟程度以及它们对 FSH 和管内睾酮（T）的暴露情况。这些激素有助于鉴别先天性中枢性性腺功能减退症（cHH）和体质性青春发育延迟（CDGP），并在疑似性早熟的情况下具有辅助诊断作用。此外，原发性睾丸疾病患儿存在 AMH 和/或抑制素 B 水平降低，提示存在SCs 功能障碍。TV 也可提供有关睾丸健康的有用信息。最近，开发了一种需要睾丸长度和生殖器发育阶段的医疗计算器，以便轻松计算 TV。
有证据支持 AMH、抑制素 B 和 TV 评估用于早期诊断青春期疾病和原发性睾丸损伤。我们建议所有儿童都应通过医疗计算器测量 TV，并将 AMH 和抑制素 B 测量保留给那些睾丸无生长、疑似青春期疾病或有精子发生损伤风险的儿童。这种评估方法可能有助于早期发现睾丸管损伤，从而有助于预防成年后男性不育的发生。
