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The Journal of Clinical Endocrinology & Metabolism Vol. 86, No. 11 5372-5378
Copyright © 2001 by The Endocrine Society


Other Original Articles

Micropenis and the AR Gene: Mutation and CAG Repeat-Length Analysis

Tomohiro Ishii, Seiji Sato, Kenjiro Kosaki, Goro Sasaki, Koji Muroya, Tsutomu Ogata and Nobutake Matsuo

Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan

Address all correspondence and requests for reprints to: Tomohiro Ishii, M.D., Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: tomishii{at}mac.com

Abstract

Various mutations of the AR gene and expanded CAG repeats at exon 1 of that gene have been reported in patients with hypospadias or genital ambiguity. However, the role of the AR gene has not been systemically studied in those with isolated micropenis lacking hypospadias or genital ambiguity. We studied 64 Japanese boys with isolated micropenis (age, 0–14 yr; median, 7 yr), whose stretched penile lengths were between -2.5 and -2.0 SD (borderline micropenis) in 31 patients (age, 0–13 yr; median, 8 yr) and below -2.5 SD (definite micropenis) in 33 patients (age, 0–14 yr; median, 6 yr). Mutation analysis of the AR gene was performed for exons 1–8 and their flanking introns, except for the CAG and GGC repeat regions at exon 1, by denaturing HPLC and direct sequencing, identifying a substitution of cytosine to thymine at a position -3 in the 3' splice site of intron 1 in a patient with definite micropenis. CAG repeat length at exon 1 was determined by electrophoresis with internal size markers and direct sequencing, revealing no statistically significant difference in the distribution of CAG repeat lengths [median (range) and mean ± SE: total patients with isolated micropenis, 24 (14–34) and 23.5 ± 0.38; patients with borderline micropenis, 24 (15–29) and 23.5 ± 0.53; patients with definite micropenis, 23 (14–34) and 23.5 ± 0.56; and 100 control males, 23 (16–32) and 23.5 ± 0.29] or in the frequency of long CAG repeats (percentage of CAG repeats >=26 and >=28: total patients with isolated micropenis, 17.2 and 4.7%; patients with borderline micropenis, 19.4 and 6.5%; patients with definite micropenis, 15.2 and 3.0%; and 100 control males, 21.0 and 10.0%). These results suggest that an AR gene mutation is rare and that CAG repeat length is not expanded in children with isolated micropenis.




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