Krebs Andreas, Dickhuth Karoline, Mumm Rebekka, Stier Bernhard, Doerfer Jürgen, Grueninger Dirk, Wurm Michael, Brichta Corinna, Schwab Karl Otfried
Faculty of Medicine, Department of Pediatrics and Adolescence Medicine, University of Freiburg, Freiburg, Germany.
Faculty of Medicine, Department of Nuclear Medicine, University of Freiburg, Freiburg, Germany.
J Pediatr Endocrinol Metab. 2019 Mar 26;32(3):287-294. doi: 10.1515/jpem-2018-0451.
Background During pubertal development in healthy boys, increased levels of different sex steroids occur which are responsible for sexual maturation and physical changes. However, relationships between various sex hormones and pubertal development stages have not been sufficiently studied. Methods The investigation included 165 normal boys (mean age 12.7±2.8 years, mean body mass index [BMI] 19.6±4.2 kg/m2). Pubic hair (PH) stages were stratified by Tanner and testicular volume (TV) by means of the Prader orchidometer and assigned to the prepubertal, pubertal and postpubertal development phase. Four different sex steroids (testosterone [TE], dehydroepiandrosterone [DHEA]/dehydroepiandrosterone-sulfate [DHEAS], androstenedione (AE), 17-hydroxyprogesterone [17-OHP]) were measured in saliva by enzyme-linked immunosorbent assay (ELISA) and as serum total steroids by different assays (radioimmunoassay [RIA], chemiluminescence immunoassay [CLIA], electrochemiluminescence immunoassay [ECLIA]). Validation of saliva-based ELISA tests included data related to inter- and intra-assay coefficients of variation (CVs), recovery and linearity. Results Using Spearman rank correlation, salivary steroids significantly correlated (p<0.001) with pubertal development: TE (TV r=0.74 and PH stages r=0.72), DHEA (r=0.58 and 0.62), AE (r=0.38 and 0.45) and 17-OHP (r=0.42 and 0.43). Correlations between salivary and serum concentrations of steroids were also statistically significant (p<0.001). Binomial logistic regression analysis revealed significant correlations between salivary TE and pubertal maturation during the development phases of prepuberty-puberty and puberty-postpuberty. Inclusion of further salivary steroids did not improve analysis results. Conclusions Salivary TE permits a good non-invasive characterization of pubertal maturation stages. The consideration of further salivary sex steroids did not improve diagnostic accuracy.
在健康男孩的青春期发育过程中，不同性类固醇水平升高，这导致了性成熟和身体变化。然而，各种性激素与青春期发育阶段之间的关系尚未得到充分研究。方法：该研究纳入了165名正常男孩（平均年龄12.7±2.8岁，平均体重指数[BMI]19.6±4.2kg/m²）。阴毛（PH）阶段根据坦纳分级法进行分层，睾丸体积（TV）通过普拉德睾丸测量器进行测量，并分为青春期前、青春期和青春期后发育阶段。通过酶联免疫吸附测定（ELISA）法测定唾液中四种不同的性类固醇（睾酮[TE]、脱氢表雄酮[DHEA]/硫酸脱氢表雄酮[DHEAS]、雄烯二酮[AE]、17-羟孕酮[17-OHP]），并通过不同的测定方法（放射免疫测定[RIA]、化学发光免疫测定[CLIA]、电化学发光免疫测定[ECLIA]）测定血清总类固醇。基于唾液的ELISA检测的验证包括与批内和批间变异系数（CVs）、回收率和线性相关的数据。结果：使用斯皮尔曼等级相关性分析，唾液类固醇与青春期发育显著相关（p<0.001）：TE（TV的r=0.74，PH阶段的r=0.72）、DHEA（r=0.58和0.62）、AE（r=0.38和0.45）和17-OHP（r=0.42和0.43）。唾液和血清类固醇浓度之间的相关性也具有统计学意义（p<0.001）。二项逻辑回归分析显示，在青春期前-青春期和青春期-青春期后发育阶段，唾液TE与青春期成熟之间存在显著相关性。纳入更多唾液类固醇并未改善分析结果。结论：唾液TE能够很好地对青春期成熟阶段进行非侵入性特征描述。考虑更多唾液性类固醇并不能提高诊断准确性。
