Background: Constitutional Delay of Growth and Puberty (CDGP) is a transient state of hypogonadotropic hypogonadism associated with prolongation of childhood phase of growth, delayed bone age and pubertal delay. CDGP can cause significant psychological stress and anxiety in adolescent boys. Although testosterone usage in this group has not been shown to affect the final adult height, the effect on the first year height velocity is not widely reported.
Objective and hypotheses: The aim of this study is to determine whether testosterone treatment improves the first year height velocity in boys with CDGP when compared with height velocity in boys with CDGP who go through puberty spontaneously.
Method: Retrospective growth data from 23 adolescent boys with CDGP was analysed. CDGP was diagnosed based on medical and family history, examination, and auxology and exclusion of pathology by appropriate investigations. Ten out of 23 boys received monthly testosterone injections for 36 months in total. One-way ANOVA was used to compare the height velocity between boys who received testosterone and those who proceeded through puberty spontaneously.
Results: The mean (±SD) chronological age was 13.8 year (±1.6) with a bone age of 11.6 year (±1.7) and mean baseline height SDS of −2.0 (±0.75). The mean baseline testicular volume in the treated and untreated groups was 4.5 ml (±1.2) and 4.7 ml (±1.1) respectively. The mean (& 95% CI) height velocity one year after treatment was 8.4 cm/year (7.2, 9.7) when compared to 6.1 cm/year (4.8, 7.4) in the patients who did not receive treatment [P=0.01]. There was no significant difference in the final predicted height between the 2 groups.
Conclusion: Testosterone therapy can significantly improve the first year height velocity in boys with CDGP, without influencing the final predicted height, leading to a potential reduction in anxiety and psychological distress that affects this group of children.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology