在先天性上腺增生症中的生物标志物
Irina-Alexandra Bacila1, Neil R Lawrence1, Surabhi G Badrinath2
1Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
Clinical endocrinology
|August 23, 2023
概括
监测先天性上腺增生症 (CAH) 的激素替代疗法缺乏标准化的生化标志物. 个性化荷尔蒙特征和新兴的非侵入性方法是有效的CAH管理的关键.
科学领域:
- 内分泌学 在内分泌学.
- 儿科内分泌学 儿科内分泌学
- 生物化学 生化学
背景情况:
- 在先天性上腺增生症 (CAH) 中,激素替代疗法 (HRT) 监测具有挑战性.
- 缺乏标准化的监测策略导致CAH管理的临床变异性.
- 目前用于CAH的生物化学标记在相关性和解释方面缺乏共识.
研究的目的:
- 审查关于CAH生物化学监测的现有证据.
- 讨论时间变化,生物标志物的相互关系,以及它们与治疗和结果的联系.
- 在CAH患者中确定个性化HRT的关键信息.
主要方法:
- 对已发表的关于CAH生物化学监测的证据进行系统审查.
- 对常见测量生物标志物的时间变化进行分析.
- 评估生物标志物与治疗方案和临床结果的关系.
主要成果:
- 在研究目标和方法方面存在显著的异质性.
- 建议根据每日荷尔蒙状况和药物服用时间进行个性化HRT.
- 已注意到17-基孕,安德二和的限制;11-氧化雄激素显示有前途.
- 非侵入性唾液和尿路类固醇测量正在成为可行的选择,特别是在儿科CAH.
结论:
- 个性化激素替代疗法对于CAH管理至关重要.
- 需要对新型生物标志物如11-oxygenated androgens进行进一步验证.
- 需要进行大规模的纵向研究,以将监测策略与CAH健康结果相关联.
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