Träskilä Emilia, Holopainen Elina, Mäyränpää Mikko I, Toppari Jorma, Mäkitie Outi, Laakso Saila
Children's Hospital and Paediatric Research Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Eur J Endocrinol. 2023 Apr 4;188(4):K17-K23. doi: 10.1093/ejendo/lvad034.
The aim of this study was to describe the course of puberty and hypogonadism in males with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a Finnish APECED cohort followed up between 1970 and 2020. Anthropometry, testicular volumes and FSH, LH, and testosterone concentrations were analyzed retrospectively. Forty-three males were followed up until the median age of 42.5 years (range, 16.2-74.8). All subjects fulfilled the clinical criteria for APECED. The median age at the onset of spontaneous puberty was 13.3 years (10.8-14.8). Testosterone medication was used to promote pubertal development from the median age of 14.9 years (13.5-15.7), for 0.7-3.3 years in 8 patients. The median adult height was 173.0 cm and differed from the mid-parental target height on average -1.3 SDS (P < .001). Hypogonadism was treated in 6 patients (14%). Azoospermia was found in 3 patients. Further studies are required to explore the role of the autoimmune regulator in sperm production and testicular insufficiency.
本研究旨在描述1970年至2020年间在芬兰自身免疫性多内分泌腺病-念珠菌病-外胚层营养不良(APECED)队列中男性青春期和性腺功能减退的病程。对人体测量学、睾丸体积以及促卵泡生成素(FSH)、促黄体生成素(LH)和睾酮浓度进行了回顾性分析。对43名男性进行了随访,直至年龄中位数为42.5岁(范围为16.2 - 74.8岁)。所有受试者均符合APECED的临床标准。自发青春期开始的年龄中位数为13.3岁(10.8 - 14.8岁)。从年龄中位数14.9岁(13.5 - 15.7岁)开始使用睾酮药物促进青春期发育,8名患者使用了0.7 - 3.3年。成人身高的中位数为173.0厘米,与父母身高的中位数目标相比平均低1.3标准差(P < 0.001)。6名患者(14%)接受了性腺功能减退治疗。3名患者发现无精子症。需要进一步研究以探讨自身免疫调节因子在精子生成和睾丸功能不全中的作用。