Height and body proportions of women with complete androgen insensitivity syndrome and women with gonadal dysgenesis
TS Han, D Goswami, S Trikudanathan, SM Creighton & GS Conway
Objectives: To compare height and body proportions between women with complete androgen insensitivity syndrome (CAIS) and women with gonadal dysgenesis (GD).
Design: Cross-sectional study of three groups of women with varying degrees of exposure to sex hormones and different combinations of sex chromosomes. Fourteen subjects had CAIS and 46XY (CAIS(XY)), aged (mean±S.E.M.) 42.1±2.8 years; seven had GD and 46XY (GD(XY)), aged 36.7±4.0 years; and nine had GD and 46XX (GD(XX)), aged 27.9±2.4 years.
Setting: Adult Intersex Clinic at University College London Hospitals.
Outcome measures: Anthropometry, oestrogen therapy and karyotype.
Results: GD(XY) and CAIS(XY) women had similar age at gonadectomy and duration of oestrogen deficiency. In CAIS(XY) women, regression analysis showed that age at gonadectomy related directly to adult height explaining 20% of the variance (P=0.01), i.e. late gonadectomy resulted in taller stature. GD(XY) women were significantly taller (1.76±0.03 m) than CAIS(XY) women (1.69±0.02 m) and GD(XX) women (1.69±0.03 m). All groups had similar mean BMI (23.5 kg/m2) and upper body (UB) length (0.87 m), but GD(XY) women had greater lower body (LB) length and LB:UB ratio than CAIS(XY) women and GD(XX) women (Table).
|Gonadectomy age (years)||21.3±2.5||22.1±1.6|||
|Oestrogen deficiency (years)||8.2±2.8||7.8±2.0||5.7±0.9|
|LB length (m)||0.81±0.01†||0.89±0.02||0.82±0.03*|
|Difference from GD(XY) group: *P<0.05, †P<0.01.|
Conclusions: Taller stature in late gonadectomised CAIS(XY) women suggests oestrogen deficiency in these women prior to gonadectomy. Increased LB:UB ratio in women with GD(XY) compared to the other groups implies that these subjects have the greatest degree of oestrogen deficiency in puberty. Tall stature in XY females is largely due to oestrogen deficiency and not the influence of the Y chromosome.