Anti-Müllerian hormone and testosterone serum levels are inversely related during normal and precocious pubertal development

REY, R.; LOREDEREAU-RICHARD,I.; CAREL,J.C.; BARBET,P.; CATE,R.; ROGER,M.; CHAUSSAIN,J.L.; JOSSO,N.

JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM

ENDOCRINE SOC

Año: 1993 vol. 77 p. 1220 - 1226

0021-972X

Anti-Miillerian hormone (AMH), also called Miillerian inhibiting with normal or delayed pubertal development, 4 patients with suspected androgen insensitivity, and 11 patients with either central (CPP) or gonadotropin-independent (GIPP) precocious puberty to investigate the hormonal regulatory mechanisms of AMH secretion at puberty. Similar results were Longitudinal studies An inverse relationship between AMH and T levels was demonstrated. In boys with normal or delayed puberty with T concentrations below 6.7 nmol/L, AMH values were elevated (mean + SEM, 22.4 k 3.1 pg/L) and widely dispersed. In subjects with T levels over 6.7 nmol/L, AMH levels were uniformly low (3.4 f 0.5 pg/L), except in patients with suspected androgen insensitivity. No significant relationship was were performed on four boys with CPP and two with GIPP before and found between AMH and gonadotropin levels. after treatment. At the time of diagnosis, the T concentration was high, obtained in patients with either CPP or GIPP. and AMH levels were usually low in CPP and GIPP patients alike. When appropriate treatment was initiated, the T concentration was ^ .^. normalized within 2-4 weeks, but restoration of prepubertal AMH --- . levels required several months. Mature Sertoli cells were observed in testicular biopsies performed in three patients with untreated GIPP. Our results suggest that gonadotropins are not directly implicated in repression of AMH synthesis at puberty, but, rather, that the decrease in AMH production is the consequence of an androgen-mediated, long term, reversible chain of events leading to morphological and functional maturation of the Sertoli cells. Thus, the fall in serum AMH levels appears to be an excellent marker of Sertoli cell pubertal development.