Producción CyT
Artículo
Autoría
Castro, Sebastián
;
Correa Brito, Lourdes
;
Bedecarrás, Patricia
;
Ballerini, María Gabriela
;
Sansó, Gabriela
;
Keselman, Ana
;
Cassinelli, Hamilton
;
Arcari, Andrea Josefina
;
Alonso, Guillermo F
;
Chan, Yee-Ming
;
He, Wen
;
Ropelato, María Gabriela
;
Bergadá, Ignacio
;
Cassorla, Fernando
;
Rey, Rodolfo A
;
GRINSPON, ROMINA
Fecha
2025
Editorial y Lugar de Edición
ENDOCRINE SOC
Revista
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
ENDOCRINE SOC
Resumen
Información suministrada por el agente en
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Context: Delayed puberty is a frequent complaint in males. The differential diagnosis between self-8 limited delayed puberty (SLDP) and congenital hypogonadotropic hypogonadism (CHH) is 9 challenging. Commonly used endocrine tests, focusing on stimulated levels of luteinizing hormone 10 (LH) or testosterone, are not satisfactory in making a diagnosis. Because FSH action on Sertoli 11 cells results in testis enlargement and anti-Müllerian hormone (AMH) and inhibin B increased 12 secretion, ...
Context: Delayed puberty is a frequent complaint in males. The differential diagnosis between self-8 limited delayed puberty (SLDP) and congenital hypogonadotropic hypogonadism (CHH) is 9 challenging. Commonly used endocrine tests, focusing on stimulated levels of luteinizing hormone 10 (LH) or testosterone, are not satisfactory in making a diagnosis. Because FSH action on Sertoli 11 cells results in testis enlargement and anti-Müllerian hormone (AMH) and inhibin B increased 12 secretion, and the FSH-Sertoli cell axis function is detectable during normal childhood and early 13 puberty, we tested whether the assessment of serum FSH, AMH and inhibin B would be informative 14 to distinguish between SLDP and CHH. 15 Design: We performed a prospective, nested case-control study, in a cohort of male adolescents 16 presenting with delayed puberty, comparing baseline serum reproductive hormone levels to 17 identify predictive biomarkers of CHH, after having followed all participants prospectively until a 18 final diagnosis was ascertained based on gold standard criteria (age 18 years or ≥4 years after 19 testis volume reached 4 mL). 20 Results: Of 65 participants who completed follow-up, 33 had a final diagnosis of SLDP and 32 of 21 CHH. Serum FSH, AMH and inhibin B showed better diagnostic efficiency than LH and 22 testosterone for these differential diagnoses. FSH (IU/L) x inhibin B (ng/mL) <92 and FSH (IU/L) x 23 AMH (pmol/L) <537 showed high sensitivity (>93%), specificity (≥92%), predictive values (>92%) 24 and positive likelihood ratio (>12) for CHH. The diagnostic performance remained 89.7% and 25 88.2% for FSH x inhibin B and FSH x AMH, respectively, when analyzed in patients without red 26 flags (micropenis, cryptorchidism and/or microorchidism). 27 Conclusions: Serum FSH combined with inhibin B or AMH is highly predictive to accurately 28 distinguish between SLDP and CHH in adolescent males.
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Palabras Clave
AMHself-limited 30 delayed pubertyFSHcongenital hypogonadotropic hypogonadism