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This version published online on April 4, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-2443
A more recent version of this article appeared on July 1, 2006
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Submitted on November 8, 2005
Accepted on March 24, 2006

Larger Testes and Higher Inhibin B Levels in Finnish than in Danish Newborn Boys

Katharina M. Main*, Jorma Toppari, Anne-Maarit Suomi, Marko Kaleva, Marla Chellakooty, Ida M. Schmidt, Helena E. Virtanen, Kirsten A. Boisen, Claudia M. Kai, Ida N. Damgaard, and Niels E. Skakkebæk

University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; Departments of Physiology and Paediatrics, University of Turku, Finland

* To whom correspondence should be addressed. E-mail: katharina.main{at}rh.hosp.dk.

Context: Recent studies showed that male reproductive health problems like cryptorchidism, hypospadias, testicular cancer and low sperm quality are more prevalent in Denmark than in Finland.

Objectives: We hypothesized that if fetal testicular dysgenesis contributed to these observations, differences in gonadal development and the hypothalamus-pituitary-testis axis would already be detectable perinatally. Thus, we investigated healthy newborn boys in both countries.

Design: Prospective, longitudinal population-based study.

Setting: Two primary obstetric centers at the University Hospitals of Copenhagen, Denmark, and Turku, Finland

Participants: 633 Danish / 1044 Finnish boys, born at term with appropriate weight for gestational age

Interventions: ultrasound determination of testis size at 0-3-18 months and blood sampling (n = 727) at 3 months

Main outcome measures: testicular volume, reproductive hormones

Results: Testis volume was significantly higher at all ages in Finnish than in Danish boys (medians: 98 vs. 95 mm3, 185 vs. 119 mm3 and 188 vs. 136 mm3, respectively, P < 0.00001). Testis growth from birth to 3 months was larger in Finnish than in Danish boys (mean: 75 vs. 26 mm3, P < 0.0001). Serum hormone levels were higher in Finnish than Danish boys for inhibin B (median 456 vs. 385 pg/mL, P < 0.0001), FSH (1.33 vs. 1.21 IU/L, P < 0.036) and SHBG (143 vs. 136 nmol/L, P < 0.022). Inhibin B was significantly positively correlated to testicular volume (r=0.25, P < 0.006).

Conclusions: The larger testes and higher inhibin B levels most likely represent a bigger volume of seminiferous tubules in Finnish compared with Danish boys. Although this phenomenon may be due to a genetic difference between the two countries, it may also reflect environmental factors influencing testicular development.
Key words: infant • testis • inhibin B • ultrasound • reproductive hormones




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