血清抗缪勒管激素在预测 DSD 儿童对 hCG 刺激反应中的作用。
Serum Anti-Müllerian Hormone in the Prediction of Response to hCG Stimulation in Children With DSD.
机构信息
Developmental Endocrinology Research Group, University of Glasgow, Glasgow, UK.
British Heart Foundation Centre for Research Excellence, University of Glasgow, Glasgow, UK.
出版信息
J Clin Endocrinol Metab. 2020 May 1;105(5):1608-16. doi: 10.1210/clinem/dgaa052.
INTRODUCTION
The relationship between serum anti-Müllerian hormone (AMH) and the testosterone response to human chorionic gonadotropin (hCG) stimulation test is unclear.
METHODS
Children who had hCG stimulation tests in one tertiary centre from 2001 to 2018 were included (n = 138). Serum testosterone was measured before (day 1 [D1]) and after 3 days (D4) of hCG stimulation. Sixty-one of these children also had prolonged hCG stimulation for 2 more weeks and serum testosterone measured after 21 days (D22). All children had a serum AMH measured on D1.
RESULTS
Of the 138 children, D4 testosterone was normal in 104 (75%). AMH was low in 24/138 (17%) children, and 16 (67%) of these had a low D4 testosterone. Median AMH in those who had a normal vs low D4 testosterone was 850 pmol/L (24, 2280) and 54 pmol/L (0.4, 1664), respectively (P < 0.0001). An AMH > 5th centile was associated with a low D4 testosterone in 18/118 (13%; P < 0.0001). Of the 61 children who had prolonged hCG stimulation, D22 testosterone was normal in 39 (64%). AMH was low in 10/61(16%) children and 9 (90%) of these had a low D22 testosterone. Median AMH in children who responded and did not respond by D22 was 639 pmol/L (107, 2280) and 261 pmol/L (15, 1034) (P < 0.0001).
CONCLUSION
A normal AMH may provide valuable information on overall testicular function. However, a low AMH does not necessarily predict a suboptimal testosterone response to hCG stimulation.
简介
血清抗苗勒管激素（AMH）与人绒毛膜促性腺激素（hCG）刺激试验的睾酮反应之间的关系尚不清楚。
方法
纳入 2001 年至 2018 年在一家三级中心进行 hCG 刺激试验的儿童（n=138）。在 hCG 刺激前（第 1 天[D1]）和第 3 天（D4）测量血清睾酮。其中 61 例儿童还进行了为期 2 周的延长 hCG 刺激，并在第 21 天（D22）测量血清睾酮。所有儿童均在 D1 测量血清 AMH。
结果
138 例儿童中，D4 睾酮正常 104 例（75%）。24/138（17%）例儿童 AMH 低，其中 16 例（67%）D4 睾酮低。D4 睾酮正常与低的儿童 AMH 中位数分别为 850 pmol/L（24，2280）和 54 pmol/L（0.4，1664）（P<0.0001）。AMH >第 5 百分位数与 18/118（13%；P<0.0001）例 D4 睾酮低相关。在进行延长 hCG 刺激的 61 例儿童中，D22 睾酮正常 39 例（64%）。61 例儿童中 AMH 低 10 例（16%），其中 9 例（90%）D22 睾酮低。D22 时反应和无反应的儿童 AMH 中位数分别为 639 pmol/L（107，2280）和 261 pmol/L（15，1034）（P<0.0001）。
结论
正常的 AMH 可能提供关于整体睾丸功能的有价值信息。然而，低 AMH 并不一定预示着 hCG 刺激试验的睾酮反应不佳。
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