首页 | 本学科首页   官方微博 | 高级检索  
   检索      


Major cardiac surgery induces an increase in sex steroids in prepubertal children
Institution:1. Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium;2. Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium;3. Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium;4. Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium;1. Department of Reproductive Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai 200030, China;2. Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030,China;3. Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou 310058, China;4. Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou 310058, China
Abstract:While the neuroprotective benefits of estrogen and progesterone in critical illness are well established, the data regarding the effects of androgens are conflicting. Surgical repair of congenital heart disease is associated with significant morbidity and mortality, but there are scant data regarding the postoperative metabolism of sex steroids in this setting. The objective of this prospective observational study was to compare the postoperative sex steroid patterns in pediatric patients undergoing major cardiac surgery (MCS) versus those undergoing less intensive non-cardiac surgery. Urinary excretion rates of estrogen, progesterone, and androgen metabolites (μg/mmol creatinine/m2 body surface area) were determined in 24-h urine samples before and after surgery using gas chromatography–mass spectrometry in 29 children undergoing scheduled MCS and in 17 control children undergoing conventional non-cardiac surgery. Eight of the MCS patients had Down’s syndrome. There were no significant differences in age, weight, or sex between the groups. Seven patients from the MCS group showed multi-organ dysfunction after surgery. Before surgery, the median concentrations of 17β-estradiol, pregnanediol, 5α-dihydrotestosterone (DHT), and dehydroepiandrosterone (DHEA) were (control/MCS) 0.1/0.1 (NS), 12.4/11.3 (NS), 4.7/4.4 (NS), and 2.9/1.1 (p = 0.02). Postoperatively, the median delta 17β-estradiol, delta pregnanediol, delta DHT, and delta DHEA were (control/MCS) 0.2/6.4 (p = 0.0002), ?3.2/23.4 (p = 0.013), ?0.6/3.7 (p = 0.0004), and 0.5/4.2 (p = 0.004). Postoperative changes did not differ according to sex. We conclude that MCS, but not less intensive non-cardiac surgery, induced a distinct postoperative increase in sex steroid levels. These findings suggest that sex steroids have a role in postoperative metabolism following MCS in prepubertal children.
Keywords:Cardiac surgery  Pediatric  Estrogen  Progesterone  Androgen  Gas chromatography–mass spectrometry
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号