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Submitted on April 30, 2007
Accepted on July 19, 2007
University Department of Growth and Reproduction, GR 5064, Rigshospitalet, DK-2100 Copenhagen, Denmark, Departments of Physiology and Paediatrics, University of Turku, FI-20520 Turku, Finland, Department of Andrology, University Hospital Hamburg-Eppendorf, D-20249 Hamburg, Germany, School of Molecular and Biomedical Sciences, University of Adelaide, SA 5005 Australia
* To whom correspondence should be addressed. E-mail: katrine.bay{at}rh.regionh.dk.
Context: The Leydig cell hormone insulin-like factor 3 (INSL3) is important for testicular descent. Currently, INSL3 levels in cord blood, in serum throughout childhood and in relation to congenital cryptorchidism are unknown.
Objective: To characterize INSL3 levels in cord blood, during the postnatal activation of the hypothalamic-pituitary-gonadal axis and in later childhood in normal boys and girls and in cryptorchid boys.
Design, participants: Serum from 267 three-month-old boys of a prospective study with standardised cryptorchidism classification was analysed for INSL3 (of these, 99 had also cord blood samples). Testicular position: 151 controls, 54 transiently cryptorchid and 62 persistently cryptorchid. Eight infant girls, 26 boys (4.1–10.1 years) and 13 girls (3.7–8.7 years) were also included.
Outcome measure: INSL3, age, testicular position, LH, testosterone.
Results: INSL3 levels were significantly higher (P<0.001) in cord blood and in three-month-old boys as compared to older prepubertal boys. At three months of age, INSL3 correlated significantly with LH in healthy boys. Cord blood INSL3 was significantly reduced in persistently cryptorchid boys (P=0.001), and three-month-old persistently cryptorchid boys had a significantly increased LH/INSL3 ratio (P=0.014). INSL3 was unmeasurable in girls at all ages.
Conclusions: In boys, early postnatal INSL3 is markedly higher as compared to later in childhood, presumably because it is stimulated by the transient postnatal LH-peak. INSL3 was unmeasurable in girls at all ages. Reduced cord blood INSL3 and a increased LH/INSL3 ratio at three months of age in persistently cryptorchid boys suggest impaired Leydig cell function in cryptorchid boys already in the perinatal period.
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