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三级医疗中心性发育障碍的临床流行病学概况:一项描述性观察研究。

Clinicoepidemiological Profile of Disorders of Sex Development Presenting to a Tertiary Care Center: A Descriptive Observational Study.

作者信息

Pandre Sujeet Kumar, Sharma Pramod Kumar, Chanchlani Roshan, Maheshwari Mahesh, Thanneeru Suresh Kumar, Ahmad Reyaz

机构信息

Department of Pediatric Surgery, Government Medical College, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

出版信息

J Indian Assoc Pediatr Surg. 2025 May-Jun;30(3):356-360. doi: 10.4103/jiaps.jiaps_252_24. Epub 2025 Mar 12.

DOI:10.4103/jiaps.jiaps_252_24
PMID:40406322
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094601/
Abstract

BACKGROUND AND OBJECTIVE

The prevalence of disorders of sex development (DSD) is estimated to affect approximately 1 in 4500-5500 newborns, yet there is a dearth of studies, particularly in Central India, on this topic. This study aims to identify prevalent types of DSD in this region, analyze clinical patterns, and explore associated factors to enhance medical services for DSD management.

MATERIALS AND METHODOLOGY

A prospective observational study was conducted at a tertiary care center in Central India from February 2022 to June 2023. Children presenting with conditions such as hypospadias, micropenis, and female hernia were included in the study, while those over 18 years old and specific hypospadias cases were excluded from the study. Detailed patient histories and clinical examinations focusing on external genitalia and associated anomalies were recorded to estimate DSD prevalence, positivity rates, and phenotypic correlations.

RESULTS

Among 40 patients meeting inclusion criteria (mean age: 5.38 years), 35% were diagnosed with DSD, predominantly 46 XY DSD. Five-alpha reductase deficiency was the leading cause in 46 XY DSD, while congenital adrenal hyperplasia predominated in 46 XY DSD. The study provides valuable epidemiological insights into DSD types prevalent in Central India, though limited by financial constraints precluding genetic analysis.

CONCLUSION

This study addresses the knowledge gap in Central India, which can contribute to improved understanding and management of DSD. The difference in the incidence of the common cause of DSD is different in our study compared to the existing literature because of broader inclusion criteria. This highlights the importance of evaluating children presenting with proximal penile hypospadias, undescended testes, and females with inguinal hernia for timely intervention.

摘要

背景与目的

性发育障碍(DSD)的患病率估计约为每4500 - 5500名新生儿中有1例受影响,但关于这一主题的研究匮乏,尤其是在印度中部地区。本研究旨在确定该地区DSD的常见类型,分析临床模式,并探索相关因素,以加强DSD管理的医疗服务。

材料与方法

2022年2月至2023年6月,在印度中部的一家三级医疗中心进行了一项前瞻性观察研究。患有尿道下裂、小阴茎和女性疝气等病症的儿童被纳入研究,而18岁以上的儿童和特定的尿道下裂病例被排除在研究之外。记录详细的患者病史和针对外生殖器及相关异常的临床检查,以估计DSD患病率、阳性率和表型相关性。

结果

在40名符合纳入标准的患者(平均年龄:5.38岁)中,35%被诊断为DSD,主要为46 XY DSD。5α - 还原酶缺乏是46 XY DSD的主要原因,而先天性肾上腺皮质增生在46 XY DSD中占主导地位。尽管由于资金限制无法进行基因分析,但该研究为印度中部地区常见的DSD类型提供了有价值的流行病学见解。

结论

本研究填补了印度中部地区的知识空白,有助于提高对DSD的理解和管理。由于纳入标准更广泛,我们的研究中DSD常见病因的发病率与现有文献有所不同。这凸显了对患有近端阴茎尿道下裂、隐睾和腹股沟疝的女性儿童进行评估以便及时干预的重要性。

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