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孕期母亲甲状腺功能减退对男孩小青春期的影响。

The Impact of Maternal Hypothyroidism during Pregnancy on Minipuberty in Boys.

作者信息

Kowalcze Karolina, Krysiak Robert, Obuchowicz Anna

机构信息

Department of Pediatrics in Bytom, Faculty of Health Sciences in Katowice, Medical University of Silesia, Stefana Batorego 15, 41-902 Bytom, Poland.

Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.

出版信息

J Clin Med. 2023 Dec 13;12(24):7649. doi: 10.3390/jcm12247649.

Abstract

Minipuberty is a period of increased reproductive axis activity in infancy, which seems to be implicated in the postnatal development of male genital organs. Impaired thyroid function during pregnancy is associated with an increased risk of prenatal, perinatal, and postnatal complications. The aim of this study was to investigate whether the presence of hypothyroidism during pregnancy modulates the course of male minipuberty. We compared three matched groups of male infants: sons of women with hypothyroidism uncontrolled or poorly controlled during pregnancy (group A), male offspring of women treated over the entire pregnancy with adequate doses of levothyroxine (group B), and sons born to women with no evidence of thyroid disease (group C). Salivary levels of testosterone, androstenedione, dehydroepiandrosterone sulfate, estradiol, progesterone, and 17-hydroxyprogesterone, as well as urine concentrations of FSH and LH, were assessed once a month in the first 6 months of life, and once every two months between months 6 and 12. Gonadotropin and testosterone levels during the first 6 months of life were lower in group A than in groups B and C. Differences in testosterone and gonadotropin levels were accompanied by similar differences in penile length and testicular volume. Concentrations of the remaining hormones did not differ between the study groups. The obtained results suggest that untreated or undertreated maternal thyroid hypofunction in pregnancy has an inhibitory effect on postnatal activation of the hypothalamic-pituitary-testicular axis and genital organ development in their male offspring.

摘要

小青春期是婴儿期生殖轴活动增强的时期,这似乎与男性生殖器官的出生后发育有关。孕期甲状腺功能受损与产前、围产期及产后并发症风险增加相关。本研究的目的是调查孕期甲状腺功能减退的存在是否会调节男性小青春期的进程。我们比较了三组匹配的男婴:孕期甲状腺功能减退未得到控制或控制不佳的女性的儿子(A组);整个孕期接受足量左甲状腺素治疗的女性的男性后代(B组);以及无甲状腺疾病证据的女性所生的儿子(C组)。在出生后的前6个月每月评估一次唾液中睾酮、雄烯二酮、硫酸脱氢表雄酮、雌二醇、孕酮和17-羟孕酮的水平,在6至12个月期间每两个月评估一次尿液中促卵泡生成素(FSH)和促黄体生成素(LH)的浓度。A组出生后前6个月的促性腺激素和睾酮水平低于B组和C组。睾酮和促性腺激素水平的差异伴随着阴茎长度和睾丸体积的类似差异。其余激素的浓度在各研究组之间没有差异。所得结果表明,孕期母亲甲状腺功能减退未治疗或治疗不足对其男性后代下丘脑-垂体-睾丸轴的出生后激活和生殖器官发育具有抑制作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05b3/10744195/f2f4a9b51240/jcm-12-07649-g001.jpg

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