Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach

Autores
Rey, Rodolfo Alberto; Grinspon, Romina; Gottlieb, Silvia Elisa; Pascualini, T.; Knoblovits, P.; Aszpis, S.; Pacenza, N.; Stewart Usher, J.; Bergadá, Ignacio; Campo, Stella Maris
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Normal testicular physiology results from the integrated function of the tubular and interstitial compartments. Serum markers of interstitial tissue function are testosterone and insulin-like factor 3 (INSL3), whereas tubular function can be assessed by sperm count, morphology and motility, and serum anti-Mu¨llerian hormone (AMH) and inhibin B. The classical definition of male hypogonadism refers to testicular failure associated with androgen deficiency, without considering potential deficiencies in germ and Sertoli cells. Furthermore, the classical definition does not consider the fact that low basal serum testosterone cannot be equated to hypogonadism in childhood, because Leydig cells are normally quiescent. A broader clinical definition of hypogonadism that could be applied to male patients in different periods of life requires a comprehensive consideration of the physiology of the hypothalamic- pituitary-testicular axis and its disturbances along development. Here we propose an extended classification of male hypogonadism based on the pathophysiology of the hypothalamic-pituitary-testicular axis in different periods of life. The clinical and biochemical features of male hypogonadism vary according to the following: (i) the level of the hypothalamic-pituitary-testicular axis primarily affected: central, primary or combined; (ii) the testicular cell population initially impaired: whole testis dysfunction or dissociated testicular dysfunction, and: (iii) the period of life when the gonadal function begins to fail: foetal-onset or postnatal-onset. The evaluation of basal testicular function in infancy and childhood relies mainly on the assessment of Sertoli cell markers (AMH and inhibin B). Hypergonadotropism should not be considered a sine qua non condition for the diagnosis of primary hypogonadism in childhood. Finally, the lack of elevation of gonadotropins in adolescents or adults with primary gonadal failure is indicative of a combined hypogonadism involving the gonads and the hypothalamic-pituitary axis.
Fil: Rey, Rodolfo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Grinspon, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Gottlieb, Silvia Elisa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Pascualini, T.. Hospital Italiano de Buenos Aires; Argentina
Fil: Knoblovits, P.. Hospital Italiano de Buenos Aires; Argentina
Fil: Aszpis, S.. Hospital "Carlos G. Durand"; Argentina
Fil: Pacenza, N.. Unidad Asistencial "Dr. César Milstein"; Argentina
Fil: Stewart Usher, J.. Centro Médico Haedo; Argentina
Fil: Bergadá, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Campo, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Materia
Cryptorchidism
Gonadotropins
Puberty
Sex Differentiation
Spermatogenesis
Testis
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/8127
Acceder
id CONICETDig_4c97cf20d04775178db89cbe70731405
oai_identifier_str oai:ri.conicet.gov.ar:11336/8127
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approachRey, Rodolfo AlbertoGrinspon, RominaGottlieb, Silvia ElisaPascualini, T.Knoblovits, P.Aszpis, S.Pacenza, N.Stewart Usher, J.Bergadá, IgnacioCampo, Stella MarisCryptorchidismGonadotropinsPubertySex DifferentiationSpermatogenesisTestishttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Normal testicular physiology results from the integrated function of the tubular and interstitial compartments. Serum markers of interstitial tissue function are testosterone and insulin-like factor 3 (INSL3), whereas tubular function can be assessed by sperm count, morphology and motility, and serum anti-Mu¨llerian hormone (AMH) and inhibin B. The classical definition of male hypogonadism refers to testicular failure associated with androgen deficiency, without considering potential deficiencies in germ and Sertoli cells. Furthermore, the classical definition does not consider the fact that low basal serum testosterone cannot be equated to hypogonadism in childhood, because Leydig cells are normally quiescent. A broader clinical definition of hypogonadism that could be applied to male patients in different periods of life requires a comprehensive consideration of the physiology of the hypothalamic- pituitary-testicular axis and its disturbances along development. Here we propose an extended classification of male hypogonadism based on the pathophysiology of the hypothalamic-pituitary-testicular axis in different periods of life. The clinical and biochemical features of male hypogonadism vary according to the following: (i) the level of the hypothalamic-pituitary-testicular axis primarily affected: central, primary or combined; (ii) the testicular cell population initially impaired: whole testis dysfunction or dissociated testicular dysfunction, and: (iii) the period of life when the gonadal function begins to fail: foetal-onset or postnatal-onset. The evaluation of basal testicular function in infancy and childhood relies mainly on the assessment of Sertoli cell markers (AMH and inhibin B). Hypergonadotropism should not be considered a sine qua non condition for the diagnosis of primary hypogonadism in childhood. Finally, the lack of elevation of gonadotropins in adolescents or adults with primary gonadal failure is indicative of a combined hypogonadism involving the gonads and the hypothalamic-pituitary axis.Fil: Rey, Rodolfo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Grinspon, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Gottlieb, Silvia Elisa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Pascualini, T.. Hospital Italiano de Buenos Aires; ArgentinaFil: Knoblovits, P.. Hospital Italiano de Buenos Aires; ArgentinaFil: Aszpis, S.. Hospital "Carlos G. Durand"; ArgentinaFil: Pacenza, N.. Unidad Asistencial "Dr. César Milstein"; ArgentinaFil: Stewart Usher, J.. Centro Médico Haedo; ArgentinaFil: Bergadá, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaFil: Campo, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; ArgentinaWiley2013-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/8127Rey, Rodolfo Alberto; Grinspon, Romina; Gottlieb, Silvia Elisa; Pascualini, T.; Knoblovits, P.; et al.; Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach; Wiley; Andrology; 1; 1; 1-2013; 3-162047-2927enginfo:eu-repo/semantics/altIdentifier/url/http://onlinelibrary.wiley.com/doi/10.1111/j.2047-2927.2012.00008.x/abstractinfo:eu-repo/semantics/altIdentifier/doi/10.1111/j.2047-2927.2012.00008.xinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:52:18Zoai:ri.conicet.gov.ar:11336/8127instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:52:18.986CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
title Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
spellingShingle Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
Rey, Rodolfo Alberto
Cryptorchidism
Gonadotropins
Puberty
Sex Differentiation
Spermatogenesis
Testis
title_short Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
title_full Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
title_fullStr Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
title_full_unstemmed Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
title_sort Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach
dc.creator.none.fl_str_mv Rey, Rodolfo Alberto
Grinspon, Romina
Gottlieb, Silvia Elisa
Pascualini, T.
Knoblovits, P.
Aszpis, S.
Pacenza, N.
Stewart Usher, J.
Bergadá, Ignacio
Campo, Stella Maris
author Rey, Rodolfo Alberto
author_facet Rey, Rodolfo Alberto
Grinspon, Romina
Gottlieb, Silvia Elisa
Pascualini, T.
Knoblovits, P.
Aszpis, S.
Pacenza, N.
Stewart Usher, J.
Bergadá, Ignacio
Campo, Stella Maris
author_role author
author2 Grinspon, Romina
Gottlieb, Silvia Elisa
Pascualini, T.
Knoblovits, P.
Aszpis, S.
Pacenza, N.
Stewart Usher, J.
Bergadá, Ignacio
Campo, Stella Maris
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cryptorchidism
Gonadotropins
Puberty
Sex Differentiation
Spermatogenesis
Testis
topic Cryptorchidism
Gonadotropins
Puberty
Sex Differentiation
Spermatogenesis
Testis
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Normal testicular physiology results from the integrated function of the tubular and interstitial compartments. Serum markers of interstitial tissue function are testosterone and insulin-like factor 3 (INSL3), whereas tubular function can be assessed by sperm count, morphology and motility, and serum anti-Mu¨llerian hormone (AMH) and inhibin B. The classical definition of male hypogonadism refers to testicular failure associated with androgen deficiency, without considering potential deficiencies in germ and Sertoli cells. Furthermore, the classical definition does not consider the fact that low basal serum testosterone cannot be equated to hypogonadism in childhood, because Leydig cells are normally quiescent. A broader clinical definition of hypogonadism that could be applied to male patients in different periods of life requires a comprehensive consideration of the physiology of the hypothalamic- pituitary-testicular axis and its disturbances along development. Here we propose an extended classification of male hypogonadism based on the pathophysiology of the hypothalamic-pituitary-testicular axis in different periods of life. The clinical and biochemical features of male hypogonadism vary according to the following: (i) the level of the hypothalamic-pituitary-testicular axis primarily affected: central, primary or combined; (ii) the testicular cell population initially impaired: whole testis dysfunction or dissociated testicular dysfunction, and: (iii) the period of life when the gonadal function begins to fail: foetal-onset or postnatal-onset. The evaluation of basal testicular function in infancy and childhood relies mainly on the assessment of Sertoli cell markers (AMH and inhibin B). Hypergonadotropism should not be considered a sine qua non condition for the diagnosis of primary hypogonadism in childhood. Finally, the lack of elevation of gonadotropins in adolescents or adults with primary gonadal failure is indicative of a combined hypogonadism involving the gonads and the hypothalamic-pituitary axis.
Fil: Rey, Rodolfo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Grinspon, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Gottlieb, Silvia Elisa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Pascualini, T.. Hospital Italiano de Buenos Aires; Argentina
Fil: Knoblovits, P.. Hospital Italiano de Buenos Aires; Argentina
Fil: Aszpis, S.. Hospital "Carlos G. Durand"; Argentina
Fil: Pacenza, N.. Unidad Asistencial "Dr. César Milstein"; Argentina
Fil: Stewart Usher, J.. Centro Médico Haedo; Argentina
Fil: Bergadá, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
Fil: Campo, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones Endocrinológicas; Argentina
description Normal testicular physiology results from the integrated function of the tubular and interstitial compartments. Serum markers of interstitial tissue function are testosterone and insulin-like factor 3 (INSL3), whereas tubular function can be assessed by sperm count, morphology and motility, and serum anti-Mu¨llerian hormone (AMH) and inhibin B. The classical definition of male hypogonadism refers to testicular failure associated with androgen deficiency, without considering potential deficiencies in germ and Sertoli cells. Furthermore, the classical definition does not consider the fact that low basal serum testosterone cannot be equated to hypogonadism in childhood, because Leydig cells are normally quiescent. A broader clinical definition of hypogonadism that could be applied to male patients in different periods of life requires a comprehensive consideration of the physiology of the hypothalamic- pituitary-testicular axis and its disturbances along development. Here we propose an extended classification of male hypogonadism based on the pathophysiology of the hypothalamic-pituitary-testicular axis in different periods of life. The clinical and biochemical features of male hypogonadism vary according to the following: (i) the level of the hypothalamic-pituitary-testicular axis primarily affected: central, primary or combined; (ii) the testicular cell population initially impaired: whole testis dysfunction or dissociated testicular dysfunction, and: (iii) the period of life when the gonadal function begins to fail: foetal-onset or postnatal-onset. The evaluation of basal testicular function in infancy and childhood relies mainly on the assessment of Sertoli cell markers (AMH and inhibin B). Hypergonadotropism should not be considered a sine qua non condition for the diagnosis of primary hypogonadism in childhood. Finally, the lack of elevation of gonadotropins in adolescents or adults with primary gonadal failure is indicative of a combined hypogonadism involving the gonads and the hypothalamic-pituitary axis.
publishDate 2013
dc.date.none.fl_str_mv 2013-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/8127
Rey, Rodolfo Alberto; Grinspon, Romina; Gottlieb, Silvia Elisa; Pascualini, T.; Knoblovits, P.; et al.; Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach; Wiley; Andrology; 1; 1; 1-2013; 3-16
2047-2927
url http://hdl.handle.net/11336/8127
identifier_str_mv Rey, Rodolfo Alberto; Grinspon, Romina; Gottlieb, Silvia Elisa; Pascualini, T.; Knoblovits, P.; et al.; Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach; Wiley; Andrology; 1; 1; 1-2013; 3-16
2047-2927
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://onlinelibrary.wiley.com/doi/10.1111/j.2047-2927.2012.00008.x/abstract
info:eu-repo/semantics/altIdentifier/doi/10.1111/j.2047-2927.2012.00008.x
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.13397

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