Research Unit in Analysis and Synthesis of the Evidence, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Facultad de Medicina Universidad Nacional Autónoma de Mexico, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.
Pediatr Int. 2022 Jan;64(1):e15183. doi: 10.1111/ped.15183.
Knowledge of chronic kidney disease (CKD) with pubertal disorders (PD) in adolescent boys is limited as few studies have explored this disorder. This study aimed to identify the usefulness of assessing hormonal parameters in male adolescents with CKD and their correlation with PD in a 12-month follow-up period.
A prospective cohort study was conducted among male adolescents with CKD (stages IV and V). Data regarding the age at puberty onset were collected from the patients' clinical records and through interview. The patients were followed up for 12 months during their pubertal development. At the beginning, routine hormonal profile tests were performed to examine the patients' thyroid profile, prolactin levels, luteinizing hormone, follicle-stimulating hormone, testosterone, leptin, and receptor leptin. The hormonal profiles of patients with and without PD were compared. Comparisons between the groups were performed using the Student t-test and Fisher's exact tests. Logistic regression analysis was also performed.
Data of 64 patients (26/64 with PD) were analyzed. The median age was 15 years and the median time for CKD evolution was 11 months. No differences between groups were noted in the general or biochemical characteristics of the patients. The hormonal parameters, prolactin levels were higher and the free leptin and free thyroxine levels were lower in patients with PD. Leptin receptor levels of >0.90 ng/mL (risk ratio [RR], 8.6; P = 0.004) and hyperprolactinemia (RR, 21.3; P = 0.049) were the risk factors for PD.
Leptin receptor levels of >0.90 ng/mL and hyperprolactinemia are associated with the development of PD in male adolescents with CKD.
青春期障碍（PD）合并慢性肾脏病（CKD）在青少年男孩中的知识有限，因为很少有研究探讨过这种疾病。本研究旨在评估男性青少年 CKD 患者的激素参数的有用性，并在 12 个月的随访期间评估其与 PD 的相关性。
进行了一项前瞻性队列研究，研究对象为患有 CKD（IV 和 V 期）的男性青少年。从患者的临床记录和访谈中收集青春期开始年龄的数据。在青春期发育期间，对患者进行了 12 个月的随访。开始时，对患者进行常规激素谱检查，以检查甲状腺谱、催乳素水平、黄体生成素、卵泡刺激素、睾酮、瘦素和瘦素受体。比较有和无 PD 的患者的激素谱。使用 Student t 检验和 Fisher 精确检验比较组间差异。还进行了逻辑回归分析。
分析了 64 名患者（26/64 名有 PD）的数据。中位年龄为 15 岁，CKD 演变时间中位数为 11 个月。两组患者的一般或生化特征无差异。PD 患者的催乳素水平较高，游离瘦素和游离甲状腺素水平较低。瘦素受体水平>0.90ng/mL（风险比[RR]，8.6；P=0.004）和高催乳素血症（RR，21.3；P=0.049）是 PD 的危险因素。
瘦素受体水平>0.90ng/mL 和高催乳素血症与男性青少年 CKD 患者 PD 的发生有关。
