Juul A, Müller J, Skakkebaek N E
Department of Growth and Reproduction, National University Hospital, University of Copenhagen, Denmark.
Eur J Endocrinol. 1997 Apr;136(4):401-5. doi: 10.1530/eje.0.1360401.
In healthy boys, the pituitary-gonadal axis exhibits diurnal variation in early puberty. Serum testosterone levels are higher during the night and low or immeasurable during the day. These fluctuating levels of circulating androgens in early pubertal boys are difficult to monitor. Prostate specific antigen (PSA) is a marker of the androgen-dependent prostatic epithelial cell activity and it is used in the diagnosis and surveillance of adult patients with prostatic cancer. We have measured PSA concentrations in serum from boys with precocious puberty before and during gonadal suppression with GnRH agonists to evaluate the effect of normal and precocious puberty on PSA levels and to study the correlation between testosterone and PSA in boys.
PSA was measured by an ultrasensitive immunofluorometric assay with a detection limit of 0.03 microgram/l. Testosterone was measured by an RIA with a sensitivity of 0.23 nmol/l, and sex hormone binding globulin was measured by a time-resolved immunofluorescence assay (sensitivity 0.23 nmol/l). Five boys with central precocious puberty (CPP) were studied before and after 12 months of GnRH agonist treatment. Sixty healthy boys (12 in each Tanner stage of puberty) and 37 healthy young males served as controls.
PSA levels were immeasurable in all prepubertal boys, whereas PSA levels increased with increasing stage of pubertal maturation. There was a significant correlation between PSA and testosterone and free androgen indices (r = 0.61 and r = 0.65 respectively, both P < 0.001). All 5 boys with CPP had significantly elevated PSA levels which decreased to very low or immeasurable levels after GnRH agonist treatment.
PSA may be a useful marker of testosterone activity in boys with normal or precocious puberty.
在健康男孩中，垂体 - 性腺轴在青春期早期呈现昼夜变化。血清睾酮水平在夜间较高，而在白天较低或无法测量。青春期早期男孩体内循环雄激素水平的这些波动难以监测。前列腺特异性抗原（PSA）是雄激素依赖性前列腺上皮细胞活性的标志物，用于成年前列腺癌患者的诊断和监测。我们测量了性早熟男孩在使用GnRH激动剂抑制性腺之前和期间血清中的PSA浓度，以评估正常青春期和性早熟对PSA水平的影响，并研究男孩体内睾酮与PSA之间的相关性。
采用超灵敏免疫荧光分析法测量PSA，检测限为0.03微克/升。采用放射免疫分析法测量睾酮，灵敏度为0.23纳摩尔/升，采用时间分辨免疫荧光分析法测量性激素结合球蛋白（灵敏度0.23纳摩尔/升）。对5名中枢性性早熟（CPP）男孩在GnRH激动剂治疗12个月前后进行了研究。60名健康男孩（青春期各坦纳分期各12名）和37名健康青年男性作为对照。
所有青春期前男孩的PSA水平均无法测量，而PSA水平随着青春期成熟阶段的增加而升高。PSA与睾酮及游离雄激素指数之间存在显著相关性（分别为r = 0.61和r = 0.65，均P < 0.001）。所有5名CPP男孩的PSA水平均显著升高，在GnRH激动剂治疗后降至极低或无法测量的水平。
PSA可能是正常或性早熟男孩睾酮活性的有用标志物。
