hypothalamus-pituitary-testis axis in boys during the first six months of life: a comparison of cryptorchidism and hypospadias cases with controls

It is inconclusive whether the feedback mechanisms of the hypothalamus-pituitary-testis (HTP) axis are already established in the first 6 months of life, partly due to the dramatic changes in HPT-axis hormone levels over this period. Moreover, it is unclear whether these hormone levels are aberrant...

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Bibliographic Details
Published in:International journal of andrology 2009-10, Vol.32 (5), p.453-461
Main Authors: Pierik, Frank H, Deddens, James A, Burdorf, Alex, Keizer-Schrama, Sabine M.P.F. de Muinck, Jong, Frank H. de, Weber, Rob F.A
Format: Article
Language:English
Subjects:
AHM
Biological and medical sciences
Case-Control Studies
cryptorchidism
Cryptorchidism - physiopathology
FSH
Fundamental and applied biological sciences. Psychology
Gynecology. Andrology. Obstetrics
Humans
hypospadias
Hypospadias - physiopathology
Hypothalamo-Hypophyseal System
Infant
Infant, Newborn
inhibin B
Male
Male genital diseases
Malformations of the urinary system
Mammalian male genital system
Medical sciences
Nephrology. Urinary tract diseases
newborn boys
Non tumoral diseases
Surveys and Questionnaires
testosterone
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Vertebrates: reproduction
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Summary:It is inconclusive whether the feedback mechanisms of the hypothalamus-pituitary-testis (HTP) axis are already established in the first 6 months of life, partly due to the dramatic changes in HPT-axis hormone levels over this period. Moreover, it is unclear whether these hormone levels are aberrant in boys with cryptorchidism or hypospadias, and therefore predictive for future fertility. We studied the regulation mechanisms of the HTP axis, and the effect of age, in boys 1-6 months of age. Secondly, we studied testicular function - as reflected by HPT hormones - in newborns with cryptorchidism or hypospadias. Sera from a population sample of infants with cryptorchidism (n = 43), hypospadias (n = 41) and controls (n = 113) were analyzed for inhibin B, anti-Müllerian hormone (AMH), testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and sex hormone binding globulin (SHBG). LH, testosterone, non-shbg-bound testosterone (NSBT), and AHM levels showed significant age-related trends. After age-correction, a negative correlation between FSH and inhibin B was observed (r = -0.43). The only significant group-differences were lower testosterone and NSBT levels in cryptorchidism cases, with a mean testosterone of 1.8 and 2.6 nmol/L and a mean NSBT of 0.48 and 0.70 nmol/L for cryptorchidism cases and controls, respectively. The higher levels of LH, testosterone, and NSBT in boys born pre-term or with a low birthweight indicate that abnormal prenatal development may determine postnatal testis function. Our results support the hypothesis that the inhibin B - FSH feedback loop is already functional before puberty. The lower testosterone and NSBT levels indicate that disturbed Leydig cell function can already be detected early after birth in cryptorchid boys.
ISSN:0105-6263
1365-2605
DOI:10.1111/j.1365-2605.2008.00877.x