Прогнозування перебігу гіпоандрогенії в хлопців-підлітків

Abstract

The most pathological conditions that adversely affect the reproductive function in men of mature age is formed precisely in adolescence as a result from hypoandrogenism (HA), - a decrease in the production of male sex hormones (androgens) below the age norm. Therefore, the ability to predict the course of HA in adolescent boys allows to prevent serious health problems in the future. Purpose - to determine significant prognostic criteria for adverse course of HA in adolescent boys with delayed sexual development. Materials and methods. Were examined 157 boys 14-17 years old with signs of androgen deficiency, the degree of which was based on the assessment of total testosterone (TT). The levels of gonadotropic hormones, estradiol, their ratios were studied by enzyme-linked immunosorbent assay, and the content of thyroid-stimulating hormone and free thyroxine, their ratio was determined. The lipid spectrum of blood was studied. On the basis of X-rays of the non-dominant hand and wrist determined bone age and ossification deficiency. Сonditionally unfavorable course of HA was formed in adolescent boys with severe androgen deficiency (HA 3 degree) at the level of total testosterone <4 nmol/l. Favorable course of HA was considered to be the presence of clinical signs of hypoandrogenism in adolescents with normal TT, levels more than 12 nmol/l (HA 0 degree). Results. Based on the study was identified the most informative features and calculated their prognostic coefficient. It is proved that significant informative signs of HA in adolescent boys are such as body mass index abnormalities, bone age deficit, levels and ratios of gonadotropic hormones, estradiol values and testosterone / estradiol, testosterone / luteinizing hormone ratios, thyroid stimulating hormone / free thyroxine, changes in lipid profile. To the most prognostically significant negative prognostic criteria for adverse HA in adolescent boys are excess body weight by body mass index level, significant deficit of bone age (more than 3 years), decreased luteinizing hormone levels, decreased luteinizing hormone / follicle stimulating hormone ratio, hyperestrogenism, pronounced androgenic-estrogenic disbalance, the presence of minimal thyroid dysfunction, disorders of the lipid profile. Conclusions. The developed prognostic criteria for adolescent boys with HA will make it possible to predict the further course of the disease (in the early stages of its formation pathology), what will carry out timely treatment and rehabilitation measures in adolescent boys, and this will help to improve their health. Teens with HA, who show prognostically unfavorable signs, need more careful dispensary observation of an endocrinologist. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.