RESUMO
Twenty-two prepubertal girls with hypertrichosis were studied and compared to 10 prepubertal normal girls. Hypertrichosis was assessed according to a score that considers the amount and the distribution of vellus hair in androgen- and non-androgen-sensitive areas. Serum androgen profile and free androgen index (FAI) were determined in both groups. The hypertrichosis score was higher in patients than in the normal girls. Testosterone levels and FAI were increased in patients when compared to control; 3alpha-androstanediol glucuronide levels above 2 SD from the control mean were found in 10 girls and all hormonal parameters falling in the normal range were found in 4 girls. The new score designed to assess the degree of hypertrichosis was useful to differentiate between normal and pathological hair growth. Although most of the girls with prepubertal hypertrichosis showed an increased androgen bio-availability, a slight increase in peripheral 5alpha-reductase activity and a completely normal androgen profile was also associated with a pathological hair growth.
Assuntos
Androgênios/sangue , Hipertricose/fisiopatologia , Globulina de Ligação a Hormônio Sexual/análise , Androstano-3,17-diol/análogos & derivados , Androstano-3,17-diol/sangue , Androstenodiona/sangue , Criança , Pré-Escolar , Sulfato de Desidroepiandrosterona/sangue , Diagnóstico Diferencial , Feminino , Humanos , Hipertricose/sangue , Hipertricose/diagnóstico , Valores de Referência , Testosterona/sangueRESUMO
BACKGROUND AND OBJECTIVE: Inhibins are peptides, mainly of gonadal origin, that suppress FSH production. Dimeric forms of inhibin (A and B) have been proposed as peripheral markers of Sertoli and granulosa cell function. The aim of this study was to establish the relationship between circulating dimeric and monomeric inhibins, and gonadotrophins and sex steroids, in normal boys and girls from birth to puberty. SUBJECTS: One hundred and forty-six normal children (females: 57; males: 89) were studied. MEASUREMENTS: Serum LH and FSH were measured by an immunofluorometric assay. Serum oestradiol and testosterone were measured by radioimmunoassay. Serum inhibin A and B, and Pro-alphaC, were measured by specific two-site enzyme-linked immunosorbent assays. RESULTS: In boys from birth to 6 months of age, the mean serum inhibin B concentration was as high (477 +/- 53.7 ng/l) as that found at puberty (400 +/- 70.2 ng/l). After the first year, inhibin B gradually decreased to reach its lowest concentration (153 +/- 23.6 ng/l) at age 4-6 years. At approximately age 10, it rose progressively to reach pubertal concentrations. Pro-alphaC showed a similar pattern but at lower concentrations. Inhibin A was not detected at any age. In girls from birth to 6 months, inhibin B levels (83.0 +/- 18.3 ng/l) were approximately 50% lower than those found at puberty (181 +/- 25.7 ng/l). After 6 months of age, these levels dropped (17.5 +/- 1.6 ng/l) and remained low until the prepubertal years. Thereafter, they increased to pubertal concentrations. The serum inhibin A concentration after birth (29.9 +/- 8.7 ng/l) was similar to that found at puberty (18.3 +/- 5.7 ng/l); after 6 months, it fell to undetectable levels until the prepubertal years. CONCLUSION: The sex difference in serum levels of gonadotrophins is associated with sex differences in the levels and proportions of circulating dimeric and monomeric inhibins.
Assuntos
Inibinas/sangue , Proteínas Secretadas pela Próstata , Caracteres Sexuais , Adolescente , Adulto , Análise de Variância , Biomarcadores/sangue , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Lactente , Recém-Nascido , Hormônio Luteinizante/sangue , Masculino , Peptídeos/sangue , Isoformas de Proteínas/sangue , Precursores de Proteínas/sangue , Testosterona/sangueRESUMO
OBJECTIVES: To evaluate the 24-h diuresis, urinary osmolality, plasma arginine vasopressin (AVP) and urinary prostaglandin E2 (PGE2) before and during desmopressin treatment in patients with monosymptomatic primary enuresis (MPE), and to investigate the possible depressor effect of desmopressin on the detrusor in such patients with urodynamically confirmed bladder instability. PATIENTS AND METHODS: Seven healthy children (control group) and 11 consecutive patients with MPE (mean age 10.4 years, range 7-15) were assessed using laboratory tests, renal and bladder ultrasonography, and video-urodynamic investigations. A 24-h inpatient assessment with a controlled water intake of 20 mL/kg per day included determinations of diuresis, urinary osmolality, AVP and PGE2 in both normal children and those with MPE. After 30 days of treatment at optimal doses of desmopressin, all children were hospitalized and re-evaluated during desmopressin treatment; all completed 3 months of treatment at optimal doses. At the end of this period, patients whose symptoms improved by > or = 80% were defined as 'responders' while those in whom they did not were defined as 'non-responders'. RESULTS: After treatment, six of the 11 patients with MPE were 'responders' and five 'non-responders'. Urodynamic evaluation showed bladder instability in seven of the 11 patients with MPE but in those with bladder dysfunction, urodynamic studies carried out during desmopressin treatment showed no changes in detrusor activity. There were significant differences in the morning values of AVP between normal children and responders (P < 0.03), and between responders and non-responders (P < 0.02); none of the non-responders had AVP levels of < 2.5 pg/mL, while none of the responders exceeded this value. At midnight, responders had the lowest mean AVP and non-responders the highest; this correlated with the highest PGE2 value in the nonresponders at 00.00-08.00 hours. Non-responders had an overnight mean PGE2 level greater than that in normal subjects or responders. CONCLUSIONS: Polyuria occurred in all patients with MPE, independently of the response to desmopressin. Responders had the lowest AVP values over the 24 h; the morning AVP levels differentiated normal subjects from enuretic patients and responders from non-responders. In patients with MPE, clinically undetected bladder instability was unrelated to the results of treatment and there were no urodynamic changes during desmopressin treatment. The differences between enuretic patients suggested a different aetiology of MPE, probably related to an increase in PGE2 concentration and an antagonistic mechanism of action of AVP or desmopressin.
Assuntos
Desamino Arginina Vasopressina/administração & dosagem , Enurese/tratamento farmacológico , Fármacos Renais/administração & dosagem , Administração Oral , Adolescente , Arginina Vasopressina/sangue , Criança , Dinoprostona/urina , Enurese/sangue , Enurese/urina , Feminino , Humanos , Masculino , Concentração Osmolar , Recidiva , Falha de Tratamento , Micção/fisiologia , Urina/fisiologiaRESUMO
OBJECTIVE: SHBG is a circulating glycoprotein that binds dihydrotestosterone, testosterone and oestradiol with high affinity and low capacity. In girls, serum concentrations of SHBG gradually decrease with age due to a true fall in concentration and not to a change in the binding characteristics. The aim of our study was to determine the pattern of serum SHBG isoforms in normal girls in early childhood (ECh), late childhood (LCh) and puberty (P). SUBJECTS: Fifteen normal girls were studied. They were divided into three groups according to their age: ECh: 3.7 +/- 0.9 years (mean +/- SD, n = 5); LCh: 6.4 +/- 0.5 years (n = 5); and P: 13.4 +/- 1.5 years (n = 5). METHODS AND MEASUREMENTS: Preparative isoelectric focusing was used to isolate SHBG isoforms according to their isoelectric point (pI). Three groups of isoforms were isolated: SI: pI 5.2-5.4; SII: pI 5.4-5.6 and SIII: pI 5.6-5.8. Steroid levels in serum were determined by RIA. RESULTS: The relative distribution of SHBG isoforms (% of the total SHBG recovered, mean +/- SD) in the three groups of girls studied was: ECh: SI: 25.8 +/- 9.9, SII: 53 +/- 10.5 and SIII: 21.2 +/- 1.6; LCh: SI: 8.8 +/- 3.1, SII: 58.8 +/- 12.2 and SIII: 31.8 +/- 8.6; P: SI: non-detectable; SII: 51.6 +/- 12.6 and SIII: 48.4 +/- 12.6. CONCLUSION: These results indicate that serum SHBG is more heterogeneous before puberty. A considerable proportion of acidic isoforms are present early in life; they decrease during the prepubertal period and disappear when sexual development is completed. After puberty the glycoprotein is more homogeneous and an important proportion of more basic isoforms is present. At puberty serum SHBG not only falls in concentration but also has an altered sialic acid content which modulates its circulating half-life.
Assuntos
Puberdade/sangue , Globulina de Ligação a Hormônio Sexual/análise , Adolescente , Análise de Variância , Criança , Pré-Escolar , Sulfato de Desidroepiandrosterona/sangue , Estradiol/sangue , Feminino , Fase Folicular/sangue , Meia-Vida , Humanos , Focalização Isoelétrica , Ácido N-Acetilneuramínico/análise , Isoformas de Proteínas/análise , Globulina de Ligação a Hormônio Sexual/química , Testosterona/sangueRESUMO
There is scant information on testicular steroidogenesis during postnatal development in monkeys, particularly in New World species. Our purpose was to study the in vitro steroidogenic capacity of the Cebus monkey testis from birth to advanced puberty. Fresh testicular tissue was incubated in Medium 199 with or without hCG (10 IU/ml); and levels of pregnenolone (P5), dehydroepiandrosterone (DHA), progesterone (P4), androstenedione (A), testosterone (T), dihydrotestosterone (DHT), and 3 alpha-androstanediol (3 alpha-DIOL) were measured in tissue and incubation media by RIA. To determine the predominant steroidogenic pathway, the ratio between the concentrations of the 5-ene and the 4-ene T precursors was determined, and the relative conversion of 3H-P5 and 14C-P4 to T was calculated. The number of Leydig cells per testis was determined in all experimental groups. The testes of the Cebus monkeys could produce T in vitro without the addition of gonadotropins at all ages. T and the 5-ene precursors (P5 and DHA) were the main steroids found within testicular tissue throughout postnatal development. T content per Leydig cell increased continuously with age, but testicular T concentration reached maximal levels at early puberty and did not change thereafter. The ratios between 5-ene and 4-ene T precursors ranged between 2.8 and 13.2, which suggested a predominance of the delta-5 pathway. This was confirmed by the finding that 3H-P5 was more efficiently converted to T than was 14C-P4. The T production relative to that of its d-ene precursors progressively increased to reach maximal values in late puberty.(ABSTRACT TRUNCATED AT 250 WORDS)