Altered secretion of Sertoli cells hormones in 2-year-old prepubertal cryptorchid boys: a cross-sectional study
Altered secretion of Sertoli cells hormones in 2-year-old prepubertal cryptorchid boys: a cross-sectional study
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DOI：
10.1111/andr.12373
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发表时间：
2017-07-01
期刊：
影响因子：
4.5
通讯作者：
Thonneau, P.
中科院分区：
文献类型：
--
作者：
Hamdi, S. M.;Almont, T.;Thonneau, P.
在隐睾男孩中，生殖细胞发育的失败已经明确确立。一些研究报道了支持细胞的形态异常，但关于其内分泌分泌的结果仍有争议。为了比较有隐睾症和无隐睾症的年轻男孩睾丸激素水平，我们进行了一项基于医院的横断面研究。从手术预约记录中，我们确定了一组患有单侧或双侧隐睾的男孩和一组接受牙科护理、小骨关节或皮肤手术的对照组。在手术过程中抽取血样进行睾酮、抑制素B和抗苗勒管激素（AMH）免疫测定。我们纳入了27名隐睾男孩和27名对照组，年龄分别为26.6个月和24.2个月（p = 0.172），远离产后小青春期和相应的激素激增。年龄调整后的隐睾男孩AMH和抑制素B水平明显低于对照组（AMH: 87 ng/mL vs 135 ng/mL, p = 0.009；抑制素B: 97 pg/mL vs 133 pg/mL， p = 0.019）。此外，双侧隐睾亚组的AMH和抑制素B水平显著低于对照组，分别比对照组低50% (p = 0.011和0.019)，两种激素水平在对照组中是独立的，但在双侧隐睾男孩中却呈强相关（R-2 = 0.75, p = 0.001）。此外，睾酮水平在一些男孩中仍可检测到，隐睾组的睾酮水平明显低于对照组。总的来说，2岁的隐睾患者AMH和抑制素B水平同时显著下降，提示支持细胞功能缺陷。这种缺陷在双侧隐睾中更为明显，因此，关于支持细胞在生殖细胞发育中的关键作用，它可以解释后来在出生时患有这种畸形的男性中发现的生育能力低下。
In cryptorchid boys, failures in germ cell development have been clearly established. Some studies reported some abnormalities in Sertoli cells morphology but the results regarding their endocrine secretion remain controversial. To compare testicular hormone levels in young boys with and without cryptorchidism, we performed a cross-sectional hospital-based study. From surgery appointment records, we identified a case group of boys with unilateral or bilateral cryptorchidism and a control group undergoing dental care, minor osteoarticular or dermal surgery. Blood samples were withdrawn during the surgical procedure to perform testosterone, inhibin B and anti-mullerian hormone (AMH) immunoassays. We included 27 cryptorchid boys and 27 controls aged of 26.6 vs. 24.2 months, respectively (p = 0.172) far from the post-natal mini-puberty and the corresponding hormonal surges. Age-adjusted AMH and inhibin B levels were significantly lower in cryptorchid than in control boys (AMH: 87 ng/mL vs. 135 ng/mL; p = 0.009, inhibin B: 97 pg/mL vs. 133 pg/mL; p = 0.019, respectively). Moreover, AMH and inhibin B levels were significantly lower in the bilateral cryptorchid subgroup, being 50% lower than in the controls (p = 0.011 and 0.019, respectively) and while both hormones levels were independent in controls, they became strongly correlated in bilateral cryptorchid boys (R-2 = 0.75, p = 0.001). In addition, testosterone levels were still detectable in some boys, with significantly lower levels in cryptorchid group than in controls. Overall, 2-year-old cryptorchid patients presented a simultaneous and significant drop in AMH and inhibin B levels, suggesting a functional defect of Sertoli cells. This deficiency appeared more pronounced in bilateral cryptorchidism and thus, regarding the pivotal role of Sertoli cells in germ cell development, it may explain the compromised fertility found later in men born with such a malformation.