0~6岁儿童尿促性腺激素、性激素变化趋势及特点

Trajectories and characteristics of urinary gonadotropin and sex hormones in healthy 0–6 years old children

目的研究0~6岁正常儿童尿促性腺激素和性激素变化趋势和特点,旨在为儿童小青春期、性早熟等流行病学调研和临床应用提供前期研究资料。方法于2016年5月—2017年10月,留取江苏省无锡市马山和胡埭社区0~6岁920名正常儿童过夜清晨尿,采用免疫化学发光法检测尿促性腺激素和性激素,并用肌酐(Cr)校正。结果成功留取并检测920名儿童尿液,其中男童471人,女童449人,男、女童经肌酐校正的尿黄体生成素(ULH/Cr)[M(P25~P75)]分别为29.36(17.72~65.05)和33.31(20.47~76.46)U/mol,差异无统计学意义;经肌酐校正的尿卵泡刺激素(UFSH/Cr)分别为473.37(304.15~758.17)和2414.57(1444.80~4212.84)U/mol,男童低于女童,差异有统计学意义(t=–16.61,P=0.000);经肌酐校正的尿雌三醇(UE3/Cr)分别为21.58(16.06~32.47)和24.18(18.57~35.53)μg/mol,男童低于女童,差异有统计学意义(t=–0.857,P=0.001);经肌酐校正的尿雌二醇(UE2/Cr)分别为34.89(24.08~59.87)和32.08(22.33~54.39)μg/mol,差异无统计学意义。男女童尿促性腺激素及性激素均随年龄增加而呈下降趋势。在男童,UE2/Cr自1.5岁~组下降趋缓,其余激素均自6月~组下降趋缓;在女童,ULH/Cr、UE2/Cr自2岁~组、UFSH/Cr自5岁~组、UE3/Cr自6月龄~组、UPro/Cr自3岁~组下降趋缓。结论0~6岁正常儿童尿促性腺激素及性激素均随年龄增加呈下降趋势,且具有性别和激素特点。

Objective To observe changing trends and characteristics of urinary gonadotropin and sex hormones in healthy children aged 0–6 years and to provide preliminary references for researches on mini-puberty and precocious puberty.Methods First morning urinary samples were collected from 920 healthy 0–6 years old children(471 boys and449 girls)in two communities of Wuxi city,Jiangsu province between May 2016 and October 2017;urinary gonadotropin and sex hormones were determined using immunochemiluminometric assay with creatinine(Cr)correction.Results The median(25%percentile[P25]–75%percentile[P75])of urinary luteinizing hormone corrected by creatinine(ULH/Cr)was29.36(17.72–65.05)U/mol and 33.31(20.47–76.46)U/mol in the boys and girls,without significant gender difference.The median(P25–P75)of urinary follicle stimulating hormone corrected by creatinine(UFSH/Cr)among the boys was473.37(304.15–758.17)U/mol and was significantly lower than that(2414.57[1444.80–4212.84]U/mol)among the girls(t=–16.61,P<0.001).The median(P25–P75)of urinary estriol corrected by creatinine(UE3/Cr)among the boys was21.58(16.06–32.47)μg/mol and was significantly lower than that(24.18[18.57–35.53]μg/mol)among the girls(t=–0.857,P=0.001).The median(P25–P75)of urinary estradiol corrected by creatinine(UE2/Cr)was 34.89(24.08–59.87)μg/mol and 32.08(22.33–54.39)μg/mol among the boys and girls,without significant gender difference.The urinary gonadotropin and sex hormone presented a decreasing trend with the increment of age in both the boys and the girls.The decrease in UE2/Cr slows down at the age of 1.5 years and the decreases in other sex hormones slows down at the age of6 months among the boys;while,among the girls the decreases in ULH/Cr and UE2/Cr slow down at the age of 2 years and the decreases in UFSH/Cr,UE3/C,and urinary progesterone corrected by creatinine(UPro/Cr)slow down at the age of5 years,6 months,and 3 years,respectively.Conclusion Urinary gonadotropin and sex hormone decrease with the increment of age and the decreases differ by gender and various hormones among 0–6 years old healthy children.