Final Height Outcome in Both Untreated and Testosteronetreated Boys with Constitutional Delay of Growth and Puberty

Abstract

The present retrospective study is based on a historical follow-up of 49 boys with constitutional delay of growth and puberty (CDGP) who went into puberty spontaneously (27 cases) or induced by depotestosterone treatment, 50 mg/ month for 6 months (22 cases). At the time of puberty the two groups of boys were similar in bone age, height deficiency, target height (TH) and had similar predicted final heights (FH). Their FH was measured and compared with TH calculated from measured parents' heights. FH did not significantly differ between the untreated boys and those treated. In the two groups of patients FH was similar and corresponded to both TH and height predicted at puberty onset. This study confirms that most boys with CDGP spontaneously attain a FH within the target range (24/27 cases). A short-term and low dose course of depotestosterone can be used without adverse effects on FH. The Bayley-Pinneau method can be generally considered accurate for predicting FH in CDGP, although significant discrepancies between FH and predicted height have been recorded in a fair number of both untreated and treated boys.

Progressive Reduction of Relative Height in Childhood Predicts Adult Stature below Target Height in Boys with Constitutional Delay of Growth and Puberty

“…Subjects with CDGP have previously been shown to achieve FH that is normal or lower-range normal compared with the general population, with values ranging from –1.9 to –0.6 SDs [5,6,7,8,9,10, 12]. However, not all boys with CDGP reach their genetic TH [7, 9, 10, 13].…”

“…However, not all boys with CDGP reach their genetic TH [7, 9, 10, 13]. Although in some previous studies FH of CDGP cases was only 0.1–0.2 SDs smaller than their TH [5, 8], several other studies have reported FH from 0.8 to 1.5 SDs below TH [7, 8,10,11,12,13]. According to one study, 58% of cases with CDGP did not exploit their full genetic height potential [13].…”

“…Accordingly, in the present study, subjects who did not have an early height SD reduction and who had a greater minimum relative height attained a FH closer to TH than boys who had had a clear decrease in relative height before puberty. In a study of 49 CDGP patients, 3 boys who failed to reach adult stature within TH (FH from 8.6 to 11 cm below TH) were the smallest at diagnosis [8]. Two previous studies have demonstrated that height SD reduction already after 4 or 6 years of age does not adversely affect FH [4, 5].…”

“…At least in a subgroup of CDGP subjects, the reduction in height SDs starts already early in childhood, well before puberty [4, 5]. Although boys with CDGP may be short during pubertal years, many will achieve a final adult height (FH) that is normal compared with the general population [5,6,7,8,9]. However, some subjects with CDGP have been shown to attain a FH that is significantly (>0.8 SDs) below their genetic target height (TH) [7,10,11,12,13].…”

“…The effects of androgen treatment on FH have been investigated in several previous studies [8,13,14,15,16,17]. These studies have, however, used a wide variety of androgen preparations and doses.…”