Ali Muhtar TİFTİK, Levent SARIYILDIZ, Turan AKDAĞ

A comparative investigation of anti-Müllerian hormone (AMH) and various biochemical parameters in patients with cryptorchidism, oligospermia, or varicocele

Amaç: Kriptorşit, oligospermi ve varikosel tanılı hastalarda AMH ve farklı biyokimyasal parametrelerin kıyaslanması yoluyla değişimin saptanması. Yöntem ve gereç: Çalışmaya 18-24 yaş arası varikosel (n = 20), oligospermi (n = 20) ile 8-12 yaş arası kriptorşit (n = 20) hasta grupları; 8-12 yaş arası (n = 20) ve 18-24 yaş arası (n = 20) sağlıklı bireyler kontrol gruplar olarak alındı. Hasta ve kontrol gruplarından kan örnekleri alınarak AMH, testosteron, FSH, LH, ve prolaktin parametreleri çalışıldı. Bulgular: Çalışmada pubertal dönemde (8-12 yaş arası) 20 kriptorşitli çocuk ile 20 normal çocuk AMH değerleri sırasıyla 73,04 ± 44,5 ng/mL ve 84,81 ± 59,1 ng/mL olarak bulunurken (P = 0,56) postpubertal dönemde (18-24 yaşarası) 20 oligospermili hasta ile 20 normal birey AMH değerleri sırasıyla 5,19 ± 4,9 ng/mL ve 7,66 ± 5,6 ng/mL (P = 0,10) ve 20 varikoselli hasta ile 20 normal birey AMH değerleri ise sırasıyla 7,15 ± 5,8 ng/mL ve 7,66 ± 5,6 ng/mL (P = 0,82) olarak saptandı. Sonuç: AMH düzeylerinin belirlenmesine yönelik daha geniş katılımcı ile yapılacak yeni çalışmalarla varikosel, oligospermi ve kriptorşidik vakalarda serum AMH ölçümünün tanı kriteri olabileceği düşünülmektedir.

Kriptorşit, oligospermi ve varikoselli hastalarda anti-müllerian hormon (AMH) ve farklı biyokimyasal parametrelerin karşılaştırılması

Aim: To investigate the serum AMH and various biochemical parameter levels in patients with cryptorchidism, oligospermia, or varicocele. Materials and methods: Th is study included 100 participants, divided into 5 groups: cryptorchidism (n = 20), varicocele (n = 20), oligospermia (n = 20), and 2 control groups [control 1, 8-12 years old (n = 20) and control 2, 18-24 years old (n= 20)]. Using the blood samples drawn from both patient and control groups, AMH, testosterone, FSH, LH, and prolactin parameters were investigated. Results: AMH values measured were found to be 73.04 ± 44.5 ng/mL and 84.81 ± 59.1 ng/mL in 20 children with cryptorchidism and 20 healthy children (both groups aged between 8 and 12 years), respectively (P = 0.56). In the present study, AMH values were found to be 5.19 ± 4.9 ng/mL and 7.66 ± 5.6 ng/mL in 20 patients with oligospermia and 20 healthy individuals (both groups aged between 18 and 24 years), respectively (P = 0.10). AMH values in 20 patients with varicocele and 20 healthy controls aged between 18 and 24 years were determined to be 7.15 ± 5.8 ng/mL and 7.66 ± 5.6 ng/ mL, respectively (P = 0.82). No signifi cant P values were determined, but the decrease in values was remarkable. Conclusion: New studies with larger number of participants are needed in order to determinate AMH levels in patients with varicocele, cryptorchidism, or varicocele for diagnostic criteria.

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1. Massague J. The transforming growth factor-beta family. Annu Rev Cell Biol 1990; 6: 597-641.
2. Rajpert-De ME, Jorgensen N, Graem N, Müller J, Cate RL, Skakkebaek NE. Expression of anti-Müllerian hormone during normal and pathological gonadal development: association with differentiation of Sertoli and granulosa cells. J Clin Endocrinol Metab 1999; 84: 3836-3844.
3. Rodolfo R. Anti-Müllerian hormone in disorders of sex determination and differentiation. Arq Bras Endocrinol Metab 2005; 49: 26-36.
4. AH Lane, PK Donahoe. New insights into Mullerian inhibiting substance and its mechanism of action. J Endocrinol 1998; 158: 1-6.
5. Kumar A, Karla B, Patel A, McDavid L, Roudebush WE. Development of a second generation Anti-Müllerian hormone (AMH) ELISA. J Immunol Methods 2010; 362: 51-59.
6. Al-Qahtani A, Muttukrishna S, Appasamy M, Johns J, Cranfield M, Visser JA et al. Development of a sensitive enzyme immunoassay for anti-Müllerian hormone and the evaluation of potential clinical applications in males and females. Clin Endocrinol 2005; 63: 267-273.
7. Grinspon RP, Rey RA. Anti-müllerian hormone and sertoli cell function in pediatric male hypogonadism. Horm Res Paediatr 2010; 73: 81-92.
8. Josso N, Racine C, di Clemente N, Rey R, Xavier F. The role of anti-Müllerian hormone in gonadal development. Mol Cell Endocrinol 1998; 145: 3-7.
9. Griffi n JE, Ojeda S. Textbook of Endocrinology. New York: Oxford University Press; 1988.
10. Goodman MH. Basic Medical Endocrinology. 3rd ed. USA: Elsevier Science; 1988.
11. Serge N, Luis FP. Hormones in male sexual development. Genes Dev 2000; 14: 3075-3086.
12. Aksglaede L, Sørensen K, Boas M, Mouritsen A, Hagen C, Jensen R et al. Changes in Anti-Müllerian Hormone (AMH) throughout the life span: a population-based study of 1027 healthy males from birth (cord blood) to the age of 69 years. J Clin Endocrinol & Metabol 2010; 95: 5357-5364.
13. Josso N, Boussin L, Knebelmann B, Nihoul-Fékété C, Picard JY. Anti-Müllerian hormone and intersex states. Trends Endocrinol Metabol 1991; 2: 227-233.
14. Josso N, Racine C, di Clemente N, Rey R, Xavier F. The role of anti-Müllerian hormone in gonadal development. Mol Cell Endocrinol 1998; 145: 1-2.
15. World Health Organization. Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction. 4th ed. New York: Cambridge University Press; 1999.
16. Wackerly D, Mendenhall W, Scheaffer RL. Mathematical Statistics with Applications. USA: Th omson Learn; 2002.
17. Lee MM, Misra M, Donahoe PK, MacLaughlin DT. MIS/AMH in the assessment of cryptorchidism and intersex conditions. Mol Cell Endocrinol 2003; 211: 91-8.
18. Demircan M, Akinci A, Mutus M. The effects of orchiopexy on serum anti-Müllerian hormone levels in unilateral cryptorchid infants. Pediatr Surg Int 2006; 22: 2713.
19. Rey R, Lordereau-Richard I, Carel JC, Barbet P, Cate RL, Roger M et al. Anti-Müllerian hormone and testosterone serum levels are inversely during normal and precocious pubertal development. J Clin Endocrinol Metab 1993; 77: 1220-6.
20. Yamanaka J, Baker M, Metcalfe S, Hutson JM. Serum levels of Mullerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg 1991; 26: 621-3.
21. Najiba L, Ilene F, Jean-Claude C, Marc R. Inhibin B and Anti- Müllerian hormone, but not testosterone levels, are normal in infants with nonmosaic Klinefelter syndrome. J Clin Endocrinol & Metabol 2004: 89; 1864-1868.
22. Baker ML, Metcalfe SA, Hutson JM. Serum levels of Müllerian inhibiting substance in boys from birth to 18 years, as determined by enzyme immunoassay. J Clin Endocrinol Metabol 1990; 70: 11-5.
23. Trigo RV, Bergadá I, Rey R, Ballerini MG, Bedecarrás P, Bergadá C et al. Altered serum profi le of inhibin B, Pro-alpha C and anti-Müllerian hormone in prepubertal and pubertal boys with varicocele. Clin Endocrinol 2004; 60: 758-64.
24. Pierik FH, Burdorf A, de Jong FH, Weber RF. Inhibin B: a novel marker of spermatogenesis. Ann Med 2003; 35: 12-20.
25. V Sriraman, E. Niu, JR Matias, PK. Donahoe, DT MacLaughlin, MP Hardy et al. Müllerian inhibiting substance inhibits testosterone synthesis in adult rats. J Androl 2001; 22: 750-8.
26. Salhi I, Cambon-Roques S, Lamarre I, Laune D, Molina F, Pugnière M et al. The anti-Müllerian hormone type II receptor: insights into the binding domains recognized by a monoclonal antibody and the natural ligand. Biochem J 2004; 379: 785-93.
27. Kevenaar ME, Th emmen AP, Rivadeneira F, Uitterlinden AG, Laven JS, van Schoor NM et al. A polymorphism in the AMH type II receptor gene is associated with age at menopause in interaction with parity. Hum Reprod 2007; 22: 2382-8.
28. Bédécarrats GY, ONeill FH, Norwitz ER, Kaiser UB, Teixeira J. Regulation of gonadotropin gene expression by Mullerian inhibiting substance. Proc Natl Acad Sci USA 2003; 100: 9348- 53.