ESPE Abstracts

Background and objective: Delayed puberty is defined as a lack of the physical signs of puberty in boys by 14 years or beyond the reference age of population standards. This study aims to evaluate the pubertal development and final height (FH) outcome in patients presented with delayed puberty due to hypogonadotropic hypogonadism (HH) and constitutional delay in growth and puberty (CDGP).

Design and participants: The hospital files of 1654 male patients older than 14 years of age who were evaluated for delayed puberty between 01.012002 and 01.04.2022 in Hacettepe University İhsan Doğramacı Children's Hospital Pediatric Endocrinology Department outpatient clinics were reviewed retrospectively. 191 patients who met the inclusion criteria were included in the study.

Results: The mean age of admission of the patients included in the study was 14.59±0.92 years (Range:3.51). The final diagnosis considered was CDGP for 149 patients while 42 patients had HH. There was a statistically significant difference between the age of presentation for patients with CDGP (14.43±0.60) and those with HH (15.15±0.99)(P=0.036). At the first presentation, the height-SDS of the patients with HH (-1.1±1.2) was higher than those with CDGP (-1.66±0.92) (P=0.03). The mean FH-SDS of patients with HH (-0.09±1) was higher than those with CDGP (-0.64±0.91) (P=0,003). In total, 118 out of 128 patients (92.2%) with CDGP and 36 out of 39 patients (92.3%) with HH had reached an FH consistent with their target height (TH). There was no statistically significant difference between the FH-SDS of patients with CDGP who received testosterone therapy for induction of puberty and those of patients who did not receive (-0.46±0.97SD, -0.74±0.87SD; P=0.094). Besides, the growth rate at six months, in the first year, and during the entire follow-up period was similar in patients who received and did not receive induction therapy.

Conclusion: Results of the present study showed that individuals presented with delayed puberty due to both CDGP and HH reaching their FH consistent with their TH to a large extent. Although patients with HH had lower growth velocity their FH was longer than those with CDGP. This was attributed to the higher presenting height and the higher TH of this patient group. Induction of puberty with testosterone in a boy with CDGP seems not to have a clinically meaningful impact on the FH and long-term pubertal progression. We, therefore, recommend an individualized approach for this group of patients.