Reversal of idiopathic hypogonadotropic hypogonadism: a cohort study in Chinese patients.
Reversal of idiopathic hypogonadotropic hypogonadism: a cohort study in Chinese patients.
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特发性性疾病性性低肿瘤的逆转：中国患者的一项队列研究。
DOI：
10.4103/1008-682x.145072
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发表时间：
2015-05
影响因子：
2.9
通讯作者：
Wu XY
中科院分区：
文献类型：
--
作者：
Mao JF;Xu HL;Duan J;Chen RR;Li L;Li B;Nie M;Min L;Zhang HB;Wu XY
虽然特发性低促性腺激素减退症(IHH)传统上被认为是由促性腺激素释放激素神经元缺陷引起的终生疾病，但在激素替代治疗过程中，部分患者可能会逐渐恢复正常的生殖轴功能。潜在的IHH逆转的预测因素在很大程度上是未知的。本研究的目的是调查男性IHH患者生殖轴功能反转的发生率和临床特点。在这项回顾性队列研究中，男性IHH患者被分为逆转组(n=18)和未逆转组(n=336)。测定促性腺激素和睾酮浓度，以及睾丸大小和精子数。在354例IHH患者中，18例(5.1%)在治疗期间获得了正常的生殖功能。逆转的中位年龄为24岁(21-34岁)。与未逆转组相比，可逆组初诊时基础黄体生成素(1.0±0.7Iu L-1vs0.4±0.4Iu L−1，P<0.0 5)和促黄体生成素(2 8.3±2 2.6Iu L−1比1.9±1.1Iu L−1，P<0.0 1)，睾丸大小(5.1±2.6mlvs 1.5±0.3ml，P<0.0 1)。总之，较大的睾丸大小和较高的促黄体生成素浓度是逆转的最佳参数。我们的发现表明，可逆性患者在最初诊断时可能保留部分活跃的生殖轴功能。
Although idiopathic hypogonadotropic hypogonadism (IHH) has traditionally been viewed as a life-long disease caused by a deficiency of gonadotropin-releasing hormone neurons, a portion of patients may gradually regain normal reproductive axis function during hormonal replacement therapy. The predictive factors for potential IHH reversal are largely unknown. The aim of our study was to investigate the incidence and clinical features of IHH male patients who had reversed reproductive axis function. In this retrospective cohort study, male IHH patients were classified into a reversal group (n = 18) and a nonreversal group (n = 336). Concentration of gonadotropins and testosterone, as well as testicle sizes and sperm counts, were determined. Of 354 IHH patients, 18 (5.1%) acquired normal reproductive function during treatment. The median age for reversal was 24 years old (range 21–34 years). Compared with the nonreversal group, the reversible group had higher basal luteinizing hormone (LH) (1.0 ± 0.7 IU l-1 vs 0.4 ± 0.4 IU l−1, P < 0.05) and stimulated LH (28.3 ± 22.6 IU l−1 vs 1.9 ± 1.1 IU l−1, P < 0.01) levels, as well as larger testicle size (5.1 ± 2.6 ml vs 1.5 ± 0.3 ml, P < 0.01), at the initial visit. In summary, larger testicle size and higher stimulated LH concentrations are favorite parameters for reversal. Our finding suggests that reversible patients may retain partially active reproductive axis function at initial diagnosis.