Behavioral and physical masculinization are related to genotype in girls with congenital adrenal hyperplasia
Behavioral and physical masculinization are related to genotype in girls with congenital adrenal hyperplasia
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DOI:
10.1210/jc.2003-030696
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发表时间:
2004-01-01
影响因子:
5.8
通讯作者:
Clayton, PE
中科院分区:
文献类型:
--
作者:
Hall, CM;Jones, JA;Clayton, PE
Girls with congenital adrenal hyperplasia (CAH) exhibit behavioral masculinization. There is controversy about the roles of pre- and postnatal androgens, social factors, and chronic illness in its etiology.To assess the effect of chronic illness, we compared behavioral masculinity in 24 CAH girls and 25 diabetic girls aged 3 - 12 yr from Manchester using two sensitive questionnaires, and an overall masculinity score M (high = masculine) was derived.To assess the contributions of pre- and postnatal androgens, the CAH subjects were categorized into genotype groups ( G) according to the reported severity of loss of CYP21 function: G1 ( n = 10, null mutations), G2 ( n = 9, intron 2G), G3 ( n = 3, I172N), and G4 ( n = 2, unknown loss of function). In CAH girls, relationships between G, Prader degree of genital masculinization at birth, bone age advance, and M were assessed. CAH girls were less feminine and more masculine than diabetic girls ( P < 0.001), who were not significantly different from U. S. controls. Among the CAH girls, those in G1 and 2 were more genitally masculinized than those in G3 and 4 ( P < 0.009) and had higher M ( P < 0.025). M was negatively correlated with advanced bone age (r = - 0.5; P = 0.02).CAH girls, but not diabetic girls, demonstrated behavioral masculinization. Both physical and behavioral masculinization were related to each other and to genotype, indicating that behavioral masculinization is a consequence of prenatal androgen exposure.