Background: Infertility is one of the major problems in adult males with congenital adrenal hyperplasia (CAH), associated with the development of testicular adrenal rest tumors (TART). Sertoli cell dysfunction could be diagnosed not only in adults but in adolescence.
Objective and Hypotheses: To study Inhibin B and AMH levels in adolescents with CAH and TART and its diagnostics value in access of Sertoli cell function.
Method: We studied 28 CAH (16 with salt-wasting form (SW) and 12 simple virilizing (SV) form) and 18 healthy adolescents. TARTs have been detected in seven CAH patients with SW form. CAH patients were divided into two groups according to TART development. CAH and control groups were comparable in chronological age (P=0.61) and puberty stage (P 0.61). CAH patients with and without TART had no differences in chronological age (P=0.53), puberty stage (P 0.72) or testicular volume (P=0.11).
Results: Patients with CAH had lower testicular volume compared to the control group (P=0.002). Lower values for inhibin B (P=0.003) but not AMH (P=0.6) were observed in the CAH patients. Inhibin B was significantly lower in patients with TART (P=0.02) in comparison to the patients without TART. There were no differences in AMH values between patients with or without TART.
|Patients||Age (Years)||Testicular volume (ml)||Inhibin B (pg/ml)||AMH (ng/ml)|
|CAH with TART||7||14.55 (10.41;17,93)||5.98 (3.79;6.84)||103.15 (60.71;166.10)||8.11 (4.07;13.17)|
|CAH without TART||21||12.82 (11.73;15.13)||8.37 (4.48;10.61)||187,45 (154.97;224.26)||8.16 (6.47;21.6)|
|Control group||18||14.5 (14.00;17.00)||10.95 (8.33;12.24)||249.12 (204.04;343.19)||8.38 (5.81;10.00)|
Conclusion: Low levels of inhibin B in CAH patients indicates Sertoli cell dysfunction especially in patients with TART.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology