Estimations of total serum testosterone levels in Nigerian term neonates at birth using anogenital distance measurements
-
Abiodun John Kareem
,
Joshua Aderinsola Owa
Abstract
Background
In genital anomalies, measurement of total testosterone is required but is expensive and technically difficult to assay. Therefore, the measurement of anogenital distance, which is non-invasive and cheap, could be used to estimate total serum testosterone in neonates. The objective if this study is to determine the relationship between total serum testosterone and anogenital distance and estimate total serum testosterone levels in term neonates using measurements of anogenital distance.
Methods
This was a prospective cross-sectional study. Consecutive healthy term neonates were recruited in the first 72 h of postnatal life. Anogenital distance was measured with a digital vernier calliper. Total serum testosterone was determined using enzyme linked immunoassay.
Results
A total of 240 term neonates comprising 124 (51.7%) males and 116 (48.3%) females were studied. The overall mean anogenital distance was 19.7 (7.7) mm and 26.5 (3.7) mm for males which was more than twice 12.4 (2.3) mm for females (t = 35.3, p < 0.001, 95% confidence interval [CI], 13–14). The overall mean total serum testosterone level was 267.1 (204.8) ng/dL; and 357.4 (241.7) ng/dL in males which was more than twice of 170.6 (80.7) ng/dL for females (t = 7.9, p < 0.001, 95% CI, 144–221). There was positive correlation between total serum testosterone and anogenital distance (r = 0.425, p < 0.001). The correlation was stronger in males than in females. The linear regression equation was as follows: total serum testosterone (ng/dL) = 44.3 + 11.3*AGD (mm) with 95% CI, 8–14.
Conclusions
The known value of anogenital distance could be used to estimate total serum testosterone levels in term neonates.
Acknowledgments
Dr. O. S. Smith of the Department of Chemical Pathology of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State, Nigeria is highly appreciated for providing the laboratory support in analysing the blood samples for total serum testosterone. We also appreciate Dr. O. T. Ojo and Dr. (Mrs.) A. O. Kareem for their assistance in the analysis of the data.
Authors’ contributions: AJ Kareem – conception and design of the title, literature search, analysis and interpretation of the data, drafting of the article, revising the article critically and corresponding author. Approval of the version to be published. JA Owa – conception and design of the title, literature search, analysis and interpretation of the data, drafting of the article and revising the article critically. Approval of the version to be published. JBE Elusiyan – conception and design of the title, literature search, interpretation of the data, drafting of the article and revising the article critically. Approval of the version to be published.
Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Employment or leadership: None declared.
Honorarium: None declared.
Conflicts of interest: The authors have disclosed no potential conflicts of interest, financial or otherwise.
References
1. Matsumoto AM, Bremner WJ. Testicular disorders. In: Polonsky KS, Larsen PR, Kronenberg HM, editors. Williams textbook of endocrinology, 12th ed. Philadelphia: Elsevier Health Sciences, 2011:688–777.10.1016/B978-1-4377-0324-5.00019-5Suche in Google Scholar
2. Eisenberg ML, Jensen TK, Walters RC, Skakkebaek NE, Lipshultz LI. The relationship between anogenital distance and reproductive hormone levels in adult men. J Urol 2012;187:594–8.10.1016/j.juro.2011.10.041Suche in Google Scholar PubMed
3. Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy. Ther Clin Risk Manag 2009;5:427–48.Suche in Google Scholar
4. Mira-Escolano MP, Mendiola J, Minguez AL, Melgarejo M, Cutillas JA, et al. Longer anogenital distance is associated with higher testosterone levels in women. Biol J Obstet Gynaecol 2014;121:1359–64.10.1111/1471-0528.12627Suche in Google Scholar PubMed
5. Bratoeff E, Cabeza M, Ramirez E, Heuze Y, Flores E. Recent advances in the chemistry and pharmacological activity of new steroidal antiandrogens and 5 alpha-reductase inhibitors. Curr Med Chem 2005;12:927–43.10.2174/0929867053507306Suche in Google Scholar PubMed
6. Huhtaniemi I. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl 2014;16:192–202.10.4103/1008-682X.122336Suche in Google Scholar PubMed PubMed Central
7. Lang F, Alevizopoulos K, Stournaras C. Targeting membrane androgen receptors in tumors. Expert Opin Ther Targets 2013;17:951–63.10.1517/14728222.2013.806491Suche in Google Scholar PubMed
8. McPhaul MJ, Young M. Complexities of androgen action. J Am Acad Dermatol 2001;45:87–94.10.1067/mjd.2001.117429Suche in Google Scholar PubMed
9. Kuiri-Hanninen T, Dunkel L, Sankilampi U. Sexual dimorphism in postnatal gonadotrophin levels in infancy reflects diverse maturation of the ovarian and testicular hormone synthesis. Clin Endo 2018;89:1–7.10.1111/cen.13716Suche in Google Scholar PubMed
10. Macleod DJ, Sharpe RM, Welsh M. Androgen action in the masculinization programming window and development of male reproductive organs. Int J Androl 2010;33:279–87.10.1111/j.1365-2605.2009.01005.xSuche in Google Scholar PubMed
11. Jain VG, Singal AK. Shorter anogenital distance correlates with undescended testis: a detailed genital anthropometric analysis in human newborns. Hum Reprod 2013;9:2343–9.10.1093/humrep/det286Suche in Google Scholar PubMed
12. Jack SE. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, Geme JW, Schor NF, Richard EB, eds. Nelson textbook of pediatrics, 20th ed. Philadelphia: Elsevier Health Sciences, 2016:2586–7.Suche in Google Scholar
13. Welsh M, Saunders PTK, Fisken M, Scott HM, Hutchison GR, et al. Identification in rats of a programming window for reproductive tract masculinization, disruption of which leads to hypospadias and cryptorchidism. J Clin Invest 2008;118:1479–90.10.1172/JCI34241Suche in Google Scholar PubMed PubMed Central
14. Avidime OM, Avidime S, Olorunshola KV, Dikko AA. Anogenital distance and umbilical cord testosterone level in newborns in Zaria, Northern Nigeria. Niger J Physiol Sci 2011;26:23–8.Suche in Google Scholar
15. Thankamony A, Ong KK, Dunger DB, Acerini CL, Hughes IA. Anogenital distance from birth to 2 years: a population study. Environ Health Perspect 2009;117:1786–90.10.1289/ehp.0900881Suche in Google Scholar PubMed PubMed Central
16. Onyiriuka AN, Elusiyan JBE. Anogenital distance in healthy Nigerian full-term newborn infants. Sri Lanka J Diabetes Endocrinol Metab 2016;6:35–9.10.4038/sjdem.v6i2.7313Suche in Google Scholar
17. Thankamony A, Lek N, Carroll D. Anogenital distance and penile length in infants with hypospadias or cryptorchidism: comparison with normative data. Environ Health Perspect 2014;122:207–11.10.1289/ehp.1307178Suche in Google Scholar PubMed PubMed Central
18. Alaee E, Gharib MJ, Fouladinejad M. Penile length and anogenital distance in male newborns from different Iranian ethnicities in Golestan Province. Iran Red Crescent Med J 2014;16:e16729.10.5812/ircmj.16729Suche in Google Scholar PubMed PubMed Central
19. Sathyanarayana S, Beard L, Zhou C, Grady R. Measurement and correlates of anogenital distance in healthy newborn infants. Int J Androl 2010;33:317–23.10.1111/j.1365-2605.2009.01044.xSuche in Google Scholar PubMed PubMed Central
20. Romano-Riquer SP, Hernandez-Avila M, Gladen BC, Cupul-Uicab LA, Longnecker MP. Reliability and determinants of anogenital distance and penis dimensions in male newborns from Chiapas, Mexico. Paediatr Perinat Epidemiol 2007;21:219–28.10.1111/j.1365-3016.2007.00810.xSuche in Google Scholar PubMed PubMed Central
21. Papadopoulou E, Vafeiadi M, Agramunt S, Basagana X, Mathianaki K, et al. Anogenital distances in newborns and children from Spain and Greece: predictors, tracking and reliability. Pediatr Perinat Epidemiol 2013;27:89–99.10.1111/ppe.12022Suche in Google Scholar PubMed
22. Behzat O, Belkis K, Atilla C, Murat K. Anogenital distance in Turkish newborns. J Clin Res Pediatr Endocrinol 2011;3:122–5.Suche in Google Scholar
23. Jae YP, Gina L, Ki WO, Dong SR, Seonghun P, et al. Penile length, digit length, and anogenital distance according to birth weight in newborn male infants. Korean J Urol 2015;56:248–53.10.4111/kju.2015.56.3.248Suche in Google Scholar PubMed PubMed Central
24. Maha HM, Rania MA, Mohamed TH, Mai MSH. Penile length and cord total and free testosterone in full term male Egyptian neonates. Egyptian Pediatr Ass 2015;63:58–62.Suche in Google Scholar
25. Andrew JOW, Murray TM, Roger H, Deborah MS, Fiona JS, et al. Free testosterone levels in umbilical-cord blood predict infant head circumference in females. Dev Med Child Neurol 2010;52:227–310.Suche in Google Scholar
26. Esoterix Inc. Expected value and S.I. unit conversion table, 5th ed. Esoterix Laboratories, 2018. Available at: https://www.esoterix.com.Suche in Google Scholar
27. Rohrmann S, Sutcliffe CG, Bienstock JL, Monsegue D, Akereyeni F, et al. Racial variation in sex steroid hormones and the insulin-like growth factor axis in umbilical cord blood of male neonates. Cancer Epidemiol Biomarkers Prev 2009;18:1484–91.10.1158/1055-9965.EPI-08-0817Suche in Google Scholar PubMed PubMed Central
28. Stroud LR, Solomon C, Shenassa E, Papandonatos G, Niaura R, et al. Long-term stability of maternal prenatal steroid hormones from the National Collaborative Perinatal Project: still valid after all these years. Psychoneuroendocrinology 2007;32:140–50.10.1016/j.psyneuen.2006.11.008Suche in Google Scholar PubMed PubMed Central
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Artikel in diesem Heft
- Frontmatter
- Reviews
- Occurrence and clinical management of nonalcoholic fatty liver disease in obesity patients: a literature review
- Does obesity have an effect on the ECG in children?
- Original Articles
- Factors associated with oxidative stress status in pediatric patients with type 1 diabetes mellitus
- The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes
- Psychiatric view for disorders of sex development: a 12-year experience of a multidisciplinary team in a university hospital
- Effect of high-dose vitamin D supplementation on antibody titers to heat shock protein 27 in adolescent girls
- Effects of whole-body vibration training on bone density and turnover markers in adolescent swimmers
- Estimations of total serum testosterone levels in Nigerian term neonates at birth using anogenital distance measurements
- Inborn errors of metabolism detectable by tandem mass spectrometry in Beijing
- Identification of two novel variants in GNPTAB underlying mucolipidosis II in a Pakistani family
- Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study
- Case Reports
- First Scandinavian case of successful pregnancy during nitisinone treatment for type 1 tyrosinemia
- A novel etiologic factor of highly elevated cholestanol levels: progressive familial intrahepatic cholestasis
- Congenital hyperinsulinism due to compound heterozygous mutations in ABCC8 responsive to diazoxide therapy
- Hyperinsulinism hyperammonaemia (HI/HA) syndrome due to GLUD1 mutation: phenotypic variations ranging from late presentation to spontaneous resolution
- Corrigendum
- Corrigendum to: The effects of a 12-week jump rope exercise program on body composition, insulin sensitivity, and academic self-efficacy in obese adolescent girls
