Progressive Deceleration in Growth as an Early Sign of Delayed Puberty in Boys

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Abstract

Objective: To describe the prepubertal growth pattern in boys with delayed puberty. Methods: Growth curves for height and height velocity covering the age range 4–14 years were constructed on the basis of retrospectively obtained data in 85 boys with delayed puberty, who attained a normal final height. Results: Between the age of 4 and 14 years the height in this cohort progressively deviated from the normal reference. At the age of 4 years, the height SDS was already significantly lower (median –0.8; p < 0.001) and progressively diminished during childhood, resulting in a median height SDS of –1.1 at the age of 12 years (p < 0.001). The median final height of this cohort (–0.4) was not different from their target height (–0.2). The degree of deceleration in growth during childhood was not determined by birth weight or birth height and did not influence final height. The decline of the height velocity with age in this group of boys with delayed puberty was significantly smaller (p < 0.001) than predicted by the model of Rikken and Wit. Conclusion: Late-maturing boys often show a prepubertal deceleration in growth that starts at an early age but that does not affect final height.

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Early morning plasma testosterone is an accurate predictor of imminent pubertal development in prepubertal boys.

F. Wu, D. Brown, G Butler … (1993)

In the management of constitutional delayed growth and/or puberty, there is a need for simple tests which can assess the overall developmental maturity of the hypothalamic-pituitary-testicular axis in clinically prepubertal patients. This would enable the physician to predict the likelihood or otherwise of an individual entering puberty spontaneously within subsequent months. Based on our previous physiological data on the sequential pattern of peripubertal pituitary-testicular activation by hypothalamic GnRH, we hypothesized that the nocturnal secretion of testosterone, in response to sleep-entrained LH secretion, may provide a basis for an in vivo bioassay of neuroendocrine sexual maturity. Overnight testosterone secretion by the testis in clinically prepubertal boys was assessed with respect to their subsequent clinical progress, the target being the attainment of testicular volumes of greater than or equal to 4 mL (a clinical landmark when puberty has assuredly begun and virilization will soon follow). Forty-five prepubertal (Tanner stage G1PH1 testicular volume < or = 2 mL) boys aged 10.0-15.3 yr (mean +/- SEM 11.8 +/- 0.2) with short stature had paired plasma T concentration measured at 2000 h and 0800 h the following morning. After the initial assessment, all patients were reviewed clinically at 3-month intervals for a minimum of 21 months (mean 26.0 +/- 1.1, range 21-50 months). During this period, 38 (84.4%) patients received treatment in the form of sc human GH 2-4 IU daily or oxandrolone 2.5 mg daily by mouth to improve short-term growth although this did not have any significant effect on the subsequent timing of pubertal onset. The patients were divided according to whether 1) there was a demonstrable increase in plasma T between 2000 and 0800 h and 2) morning plasma T concentration was less than or greater than or equal to 0.7 nmol/L at their initial assessment. In those with a significant overnight T increment, 58% and 89% achieved testicular volume of greater than or equal to 4 mL after 12 and 21 months, respectively. In contrast, only 12% and 56% of patients who had not shown a T increase went into puberty by these times. In patients who had morning plasma testosterone concentrations greater than or equal to 0.7 nmol/L, 77% entered puberty within 12 months and 100% within 15 months. However, in those with a morning testosterone of less than 0.7 nmol/L, only 12.5% and 25% entered puberty within 12 and 15 months, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

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Diurnal Rhythms of Luteinizing Hormone, Follicle-Stimulating Hormone, and Testosterone Secretion before the Onset of Male Puberty

R Mitamura (1999)

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Management of the short stature due to pubertal delay in boys

L. Adan, L ADÁN, JC Souberbielle … (1994)

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Journal ID (publisher-id): HRE

Journal ID (nlm-ta): Horm Res Paediatr

Journal ID (doi): 10.1159/issn.1663-2818

Title: Hormone Research in Paediatrics

Publisher: S. Karger AG

ISSN (Print): 1663-2818

ISSN (Electronic): 1663-2826

Publication date Subscription-year: 2000

Publication date (Print): 2000

Publication date (Electronic): 21 April 2001

Volume: 54

Issue: 3

Pages: 126-130

Affiliations

^aDepartment of Pediatrics, University Hospital Antwerp, and ^b Laboratory of Human Physiology and Pathophysiology, University of Antwerp, Belgium

Article

Publisher ID: 53245 Other ID: Horm Res 2000;54:126–130

DOI: 10.1159/000053245

PubMed ID: 11357005

SO-VID: d4faf842-3b0f-48b6-8b95-d00aedaf877a

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Progressive Deceleration in Growth as an Early Sign of Delayed Puberty in Boys

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Karger: Endocrinology

Most cited references 4

Early morning plasma testosterone is an accurate predictor of imminent pubertal development in prepubertal boys.

Diurnal Rhythms of Luteinizing Hormone, Follicle-Stimulating Hormone, and Testosterone Secretion before the Onset of Male Puberty

Management of the short stature due to pubertal delay in boys

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