Low Serum Inhibin B/Follicle-Stimulating Hormones and Anti-Mullerian Hormone/Follicle-Stimulating Hormones Ratios as Markers of Decreased Germ Cells in Infants with Bilateral Cryptorchidism
Low Serum Inhibin B/Follicle-Stimulating Hormones and Anti-Mullerian Hormone/Follicle-Stimulating Hormones Ratios as Markers of Decreased Germ Cells in Infants with Bilateral Cryptorchidism
复制标题
低血清抑制素 B/卵泡刺激激素和抗苗勒氏管激素/卵泡刺激激素比率作为双侧隐睾婴儿生殖细胞减少的标志
DOI：
10.1097/ju.0000000000002344
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发表时间：
2021
期刊：
影响因子：
6.6
通讯作者：
Hayashi Y
中科院分区：
文献类型：
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作者：
Kato T;Mizuno K;Matsumoto D;Nishio H;Nakane A;Kurokawa S;Kamisawa H;Maruyama T;Iwatsuki S;Umemoto Y;Yasui T;Hayashi Y
目的在隐睾症中，生殖细胞发育障碍从婴儿期就开始出现，并可能通过支持细胞产生的激素水平的改变来反映。我们的目的是评估血清激素水平与隐睾症患者睾丸组织病理学改变与不育风险的关系。材料与方法选择2014至2019年间接受睾丸固定术的7~91个月(中位数20个月)的青春期前隐睾症男孩(122个单侧[中位数19个月(7~91)个月]，23个双侧[24个月(11~81个月)])。我们评估了治疗前睾丸的位置和大小；血清激素水平；以及每个小管横切面的平均生殖细胞数量(G/T)。结果双侧隐睾儿血清抑制素B水平和G/T显著低于单侧隐睾儿(中位数分别为96pg/mlvs125pg/ml，p=0.026；0.20vs0.65vs0.65[0-4.55]，p<；0.001)。在24个月龄的≤男童中，抑制素B/卵泡刺激素和抗苗勒氏激素/卵泡刺激素比值与G/T呈正相关(分别为12，p=0.008和p=0.019)。根据受试者操作特征曲线，低抑制素B/FSH和高FSH比值和高FSH是G/T受损的预测因素(分别为p=0.019，p=0.004和p=0.004)，而在≤24月龄的单侧隐睾儿中，血清激素水平和G/T与治疗前睾丸位置无明显差异。结论在≤24月龄男性中，低抑制素B/FSH和高FSH比值可能反映了G/T受损和未来的不育风险。
PurposeIn cryptorchidism, germ cell development failure presents from infancy and may be reflected by altered hormonal levels produced by Sertoli cells. Our object was to assess for associations between serum hormone levels and testicular histopathology in cryptorchidism with an infertility risk according to the pretreatment undescended testicular positions.Materials and MethodsPrepubertal cryptorchid boys aged 7–91 (median 20) months who underwent orchidopexy between 2014 and 2019 were included (122 unilateral [median 19 months {range 7–91}], 23 bilateral [24 months {11–81}]). We evaluated the pretreatment testicular position and size; serum hormone levels; and the mean number of germ cells per tubule transverse section (G/T). We also performed a subgroup analysis of boys aged ≤24 months at orchidopexy.ResultsSerum inhibin B levels and G/T were significantly lower in bilateral than in unilateral cryptorchid boys (median 96 [range 46–197] pg/ml vs 125 [21–354] pg/ml, p=0.026; 0.20 [0–2.59] vs 0.65 [0–4.55], p <0.001, respectively). Inhibin B/follicle-stimulating hormones (FSH) and anti-Müllerian hormone (AMH)/FSH ratios were positively correlated with G/T in bilateral cryptorchid boys aged ≤24 months (12, p=0.008 and p=0.019, respectively). Low inhibin B/FSH and AMH/FSH ratios and high FSH were predictors of impaired G/T as per receiver operating characteristic curves (p=0.019, p=0.004 and p=0.004, respectively), whereas in unilateral cryptorchid boys aged ≤24 months, serum hormone levels and G/T did not differ with the pretreatment testicular positions.ConclusionsIn bilateral cryptorchid boys aged ≤24 months at orchidopexy, low inhibin B/FSH and AMH/FSH ratios may reflect impaired G/T and future infertility risk.