ESPE2021 Free Communications Sex Development and Gender Incongruence (6 abstracts)
Reproductive hormone levels in Minipuberty as a predictor of Testicular Endocrine Function and Penile Length in Healthy Young Men: An 18-year longitudinal Cohort Study
Louise S. Henriksen 1,2 , Jørgen H. Petersen 1,3 , Niels E. Skakkebæk 1,2 , Niels Jørgensen 1,2 , Helena E. Virtanen 4 , Anders Juul 1,2 , Jorma Toppari 4,5 & Katharina M. Main 1,2
1Department of Growth and Reproduction and EDMaRC, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark.;2Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.;3Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.;4Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology and Centre for Population Health Research, University of Turku, Turku, Finland.;5Department of Paediatrics, Turku University Hospital, Turku, Finland
Background: Minipuberty denotes a period 1–6 months postnatally in boys during which a transient activation of the hypothalamic-pituitary-gonadal axis is observed. This early hormone activation can be used diagnostically in patients suspected of pituitary deficiency and differences in sex development. However, its significance for prediction of reproductive function in healthy young men is unknown.
Objective: To evaluate minipuberty as a potential ‘window of opportunity’ that allows prediction of future reproductive health in men.
Methods: In a population-based birth cohort, sons were examined 3 months postnatally and again around 19 years. Reproductive measures included reproductive hormones, penile length and testicular volume assessed by ultrasonography. For each outcome, participants were categorised in tertiles based on their minipuberty measurement, and median adult values were compared between tertiles using Mann-Whitney U test.
Results: Boys in the lower FSH tertile in minipuberty had lower FSH levels in adulthood compared to the middle (P < .01) and upper tertiles (P < .001). For inhibin B and testicular volumes, boys in the upper tertiles in minipuberty had higher inhibin B levels and larger testicular volumes, respectively, in adulthood than those in the lower tertile (P < .05). For testosterone and SHBG, boys in the upper tertiles in minipuberty had higher testosterone and SHBG, respectively, in adulthood than those in the other tertiles (P < .05). Differences in LH were non-significant. Finally, boys in the upper tertile for penile length in minipuberty had longer penile length in adulthood than those in the lower tertile (P < .05).
| Adult outcome in relation to minipuberty tertiles | |||||
| Reproductive parameters | Lower | Middle | Upper | ||
| n | Median (25–75 percentiles) | ||||
| FSH (U/L) | 149 | 2.31 | 2.92 | 3.61 | |
| (1.78–3.04) | (2.35–4.79) | (2.48–4.91) | |||
| Inhibin B (pg/mL) | 146 | 162 (132–217) | 167 (141–211) | 216 (158–249) | |
| Left testicular volume (mL) | 238 | 12.9 (11.0–15.1) | 13.7 (10.9–15.7) | 14.2 (12.3–16.5) | |
| Right testicular volume (mL) | 236 | 13.4 (11.7–15.1) | 14.0 (11.6–16.8) | 14.7 (12.6–17.0) | |
| LH (U/L) | 149 | 4.01 (3.24–4.93) | 4.17 (2.97–5.31) | 4.23 (3.04–5.70) | |
| Testosterone (nmol/l) | 150 | 19.8 (18.0–22.3) | 19.5 (16.7–23.4) | 21.9 (18.4–26.0) | |
| SHBG (nmol/l) | 149 | 31.9 (22.2–39.0) | 28.1 (23.0–35.1) | 34.3 (29.0–44.2) | |
| Penile length (cm) | 231 | 9.0 (8.0–9.6) | 9.0 (8.2–9.5) | 9.2 (8.5–10.1) | |
Conclusion: Reproductive hormones, penile length and testicular volume during minipuberty were predictive of adult outcomes. This indicates that minipuberty can be used as a ‘window of opportunity’ and a forerunner of adult reproductive health.
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