FSH and Sertoli Cell Biomarkers Accurately Distinguish Hypogonadotropic Hypogonadism From Self-limited Delayed Puberty

被引：0

作者：

Castro, Sebastian ^{[1
]}

Brito, Lourdes Correa ^{[1
,2
]}

Bedecarras, Patricia ^{[1
]}

Ballerini, Maria Gabriela ^{[1
]}

Sanso, Gabriela ^{[1
,2
]}

Keselman, Ana ^{[1
]}

Cassinelli, Hamilton ^{[1
]}

Arcari, Andrea Josefina ^{[1
]}

Alonso, Guillermo F. ^{[3
]}

Chan, Yee-Ming ^{[4
]}

He, Wen ^{[4
]}

Ropelato, Maria Gabriela ^{[1
,2
]}

Bergada, Ignacio ^{[1
]}

Cassorla, Fernando ^{[5
]}

Rey, Rodolfo A. ^{[1
,2
]}

Grinspon, Romina P. ^{[1
]}

机构：

[1] CONICET FEI, Hosp Ninos Ricardo Gutierrez, Ctr Invest Endocrinol Dr Cesar Bergada CEDIE, Gallo 1330,C1425EFD, Buenos Aires, Argentina

[2] Hosp Ninos Dr Ricardo Gutierrez, Unidad Med Traslac, C1425EFD, Buenos Aires, Argentina

[3] Hosp Italiano Buenos Aires, Div Pediat Endocrinol, C1199ABB, Buenos Aires, Argentina

[4] Boston Childrens Hosp, Dept Pediat, Div Endocrinol, Boston, MA 02115 USA

[5] Univ Chile, FCFM, Santiago 8320000, Chile

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2025年

基金：

美国国家卫生研究院;

关键词：

AMH; congenital hypogonadotropic hypogonadism; FSH; inhibin B; LH; self-limited delayed puberty; testosterone; DISTINGUISHING CONSTITUTIONAL DELAY; INHIBIN B; GROWTH; BOYS; HORMONE; SERIES;

D O I：

10.1210/clinem/dgaf062

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context Delayed puberty is a frequent complaint in males. The differential diagnosis between self-limited delayed puberty (SLDP) and congenital hypogonadotropic hypogonadism (CHH) is challenging. Commonly used endocrine tests, focusing on stimulated levels of LH or testosterone, are not satisfactory in making a diagnosis. Because FSH action on Sertoli cells results in testis enlargement and anti-M & uuml;llerian hormone (AMH) and inhibin B increased secretion, and the FSH-Sertoli cell axis function is detectable during normal childhood and early puberty, we tested whether the assessment of serum FSH, AMH, and inhibin B would be informative to distinguish between SLDP and CHH. Design We performed a prospective, nested case-control study in a cohort of male adolescents presenting with delayed puberty, comparing baseline serum reproductive hormone levels to identify predictive biomarkers of CHH, after having followed all participants prospectively until a final diagnosis was ascertained based on gold-standard criteria (age 18 years or >= 4 years after testis volume reached 4 mL). Results Of 65 participants who completed follow-up, 33 had a final diagnosis of SLDP and 32 of CHH. Serum FSH, AMH, and inhibin B showed better diagnostic efficiency than LH and testosterone for these differential diagnoses. FSH (IU/L)xinhibin B (ng/mL) < 92 and FSH (IU/L)xAMH (pmol/L) < 537 showed high sensitivity (>93%), specificity (>= 92%), predictive values (>92%), and positive likelihood ratio (>12) for CHH. The diagnostic performance remained 89.7% and 88.2% for FSH x inhibin B and FSH x AMH, respectively, when analyzed in patients without red flags (micropenis, cryptorchidism, and/or microorchidism). Conclusion Serum FSH combined with inhibin B or AMH is highly predictive to accurately distinguish between SLDP and CHH in adolescent males.

引用

页数：12