PMID- 10396363
OWN - NLM
STAT- MEDLINE
DCOM- 19990722
LR  - 20190813
IS  - 0300-0664 (Print)
IS  - 0300-0664 (Linking)
VI  - 50
IP  - 2
DP  - 1999 Feb
TI  - Serum prostate specific antigen, sex hormone binding globulin and free androgen 
      index as markers of pubertal development in boys.
PG  - 203-10
AB  - OBJECTIVE: Prostate specific antigen (PSA) expression in the prostate gland is 
      regulated by androgens. Serum levels of PSA are undetectable by routine assays in 
      normal boys. Measurable values could serve as a marker for pubertal development. 
      In order to explore this question, we measured serum PSA levels in normal boys 
      throughout puberty and examined the interrelationships with various hormonal and 
      physical developmental changes. DESIGN: Sera from 77 normal boys in Tanner stages 
      I to V (T-I to T-V) were analysed for PSA levels by a sensitive time-resolved 
      fluoro-immunometric assay (sensitivity: 0.012 microgram/l). In addition, sex 
      hormone binding globulin (SHBG), insulin like growth factor I (IGF-I), IGF 
      binding protein 3(IGFBP-3) and testosterone were measured. RESULTS: PSA was 
      detectable in 0% of Stage T-I (n = 16), 33% of T-II (n = 18), 65% of T-III (n = 
      17) and 100% of T-IV (n = 10) and T-V (n = 16) boys. PSA levels rose 
      significantly according to stage (P < 0.05). Also, there were significant (P < 
      0.05) increments in serum testosterone, IGF-I and IGFBP-3 levels from stages T-I 
      to T-IV. PSA showed a positive correlation with testosterone (r = 0.86, P < 
      0.001), IGF-I (r = 0.66, P < 0.001), and IGFBP-3 (r = 0.34, P = 0.004) levels. 
      Both PSA and these analytes, however, showed significant overlap between stages 
      T-I and T-II with only 6/18 (33%) and 12/18 (66%) of T-II subjects having PSA and 
      testosterone levels, respectively, above the T-I range. In contrast, serum SHBG 
      levels decreased markedly from stages I to II (P < 0.001). At the calculated best 
      cut-off point for SHBG of 50 nmol/l, 16/18 T-II subjects had values below the T-I 
      range (sensitivity = 89%). Because of this decrement of SHBG and the increasing 
      testosterone secretion in early puberty, the Free Androgen Index (FAI = 
      Testosterone/SHBG) could even better differentiate the onset of puberty with all 
      except one of the T-II subjects having FAI levels above the T-I range 
      (sensitivity = 94.4%). The decrease of SHBG in T-II subjects coincided with an 
      increase in total body weight (P = 0.001) and body mass index (BMI, P = 0.0003). 
      Despite the continuing pubertal rise in testosterone, SHBG levels showed a 
      rebound increment from T-II-T-III subjects (P = 0.02) with a concomitant decrease 
      in BMI (P = 0.0014). CONCLUSIONS: Prostate specific antigen closely reflects 
      serum free androgen activity during puberty. However, it was unable to 
      differentiate the earliest pubertal development. In comparison, SHBG levels and 
      Free Androgen Index are more sensitive markers for the onset of puberty in boys. 
      The inverse association between SHBG levels and BMI in pubertal stages Tanner 
      stages, I to III suggests that body fatness, via its effect on insulin 
      sensitivity, may play an important role in the regulation of SHBG production 
      during early pubertal development.
FAU - Kim, M R
AU  - Kim MR
AD  - Cleveland Clinic Foundation, OH 44195-5131, USA.
FAU - Gupta, M K
AU  - Gupta MK
FAU - Travers, S H
AU  - Travers SH
FAU - Rogers, D G
AU  - Rogers DG
FAU - Van Lente, F
AU  - Van Lente F
FAU - Faiman, C
AU  - Faiman C
LA  - eng
PT  - Journal Article
PL  - England
TA  - Clin Endocrinol (Oxf)
JT  - Clinical endocrinology
JID - 0346653
RN  - 0 (Biomarkers)
RN  - 0 (Sex Hormone-Binding Globulin)
RN  - 3XMK78S47O (Testosterone)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adolescent
MH  - Analysis of Variance
MH  - Biomarkers/blood
MH  - Body Mass Index
MH  - Body Weight
MH  - Child
MH  - Humans
MH  - Male
MH  - Prostate-Specific Antigen/*blood
MH  - Puberty/*blood
MH  - Sex Hormone-Binding Globulin/*analysis
MH  - Statistics, Nonparametric
MH  - Testosterone/*blood
EDAT- 1999/07/09 00:00
MHDA- 1999/07/09 00:01
CRDT- 1999/07/09 00:00
PHST- 1999/07/09 00:00 [pubmed]
PHST- 1999/07/09 00:01 [medline]
PHST- 1999/07/09 00:00 [entrez]
AID - 10.1046/j.1365-2265.1999.00636.x [doi]
PST - ppublish
SO  - Clin Endocrinol (Oxf). 1999 Feb;50(2):203-10. doi: 
      10.1046/j.1365-2265.1999.00636.x.