Dickerman Z, Bar-Haim Y, Prager-Lewin R, Kaufman H, Laron Z
Acta Endocrinol (Copenh). 1977 Jul;85(3):459-64.
Nineteen boys with irregular puberty (IP), defined as a discrepancy of two or more pubertal stages between the criteria for genitalia and that for pubic hair, were subjected to a standard LRH test (50 microng/m2, iv) and the response of gonadotrophins as well as the basal levels of plasma testosterone, LH and FSH were compared to those of boys with normal, regular puberty. When the results were plotted against the pubertal stage for genitalia (Pg), it was found that in the boys with IP the basal plasma testosterone levels were lower and the response of plasma LH to LRH stimulation lesser than in the controls. However, when these parameters were plotted against the pubertal stage for pubic hair (Ph) it was found, that in the boys with IP the plasma testosterone levels were significantly higher and the response of both LH and FSH stimulation greater than in the control group. It was concluded that irregular puberty in boys may be regarded as a normal variation. The delayed development of sexual hair and penile length, and retarded pubertal growth spurt and bone age maturation seen in these boys, with normal testicular development, may be explained by a temporary reduced peripheral sensitivity to androgens and a compensatory effort by the pituitary, manifested in increased secretion of LH and testosterone, relatively to their pubertal stage for pubic hair.
19名青春期发育异常（IP）男孩，其定义为生殖器发育标准与阴毛发育标准之间存在两个或更多青春期阶段的差异，接受了标准的促性腺激素释放激素（LRH）试验（50微克/平方米，静脉注射），并将促性腺激素的反应以及血浆睾酮、促黄体生成素（LH）和促卵泡生成素（FSH）的基础水平与青春期发育正常、规律的男孩进行比较。当将结果与生殖器青春期阶段（Pg）作图时，发现IP男孩的血浆睾酮基础水平较低，血浆LH对LRH刺激的反应比对照组小。然而，当将这些参数与阴毛青春期阶段（Ph）作图时，发现IP男孩的血浆睾酮水平显著较高，LH和FSH刺激的反应均大于对照组。得出的结论是，男孩青春期发育异常可被视为一种正常变异。这些男孩生殖器发育正常，但出现性毛和阴茎长度发育延迟、青春期生长突增和骨龄成熟延迟，可能是由于外周对雄激素的敏感性暂时降低以及垂体的代偿性努力所致，表现为相对于阴毛青春期阶段，LH和睾酮分泌增加。
