Testosterone treatment of constitutional delay in growth and development: effect of dose on predicted versus definitive height

Abstract

The outcome of treatment in 3 groups of boys with constitutional delay in growth and development given monthly intramuscular injections of testosterone enanthate 200 mg (22 subjects) 100 mg (10 subjects) and 50 mg (12 subjects) was compared with the outcome in a control group (14 subjects) without treatment. The 4 groups were similar in chronological age, height, height age, bone age, height age/bone age ratio, pubertal development and had similar predicted adult heights. All treated subjects achieved an excellent growth response with growth velocities reflecting androgen dose. Bone age advanced commensurate with height age in all the treated groups and \g=D\height age/\g=D\ bone age ratios at the end of therapy did not differ significantly. Nor was there a significant difference in the height prediction by the RWT method before and at the end of treatment. However, the year following treatment, growth velocities reversed so that those who received the largest steroid dose and had grown the fastest, decelerated the most and eventually ended up significantly shorter than their predicted adult height. In contrast the control group and those treated with smaller doses of testosterone & Hintz R L (1982): A prospective randomized study of testosterone treatment of constitutional delay in growth and development in male adolescents. Pediatrics 69:681-687. Sobel , Raymond C S, Quinn V & Talbot (1956): The use of methyl testosterone to stimulate growth: Relative influence on skeletal maturation and linear growth.

Constitutional Delay of Growth and Puberty: Do They Really Reach Their Target Height?

“…Generally. CDGP is regarded as a nor mal variant of growth in childhood with a good final prognosis [4,[13][14][15][16], In our study we could show that bone age and growth were retarded to the same degree as it had been observed previously [7], When this delay in skeletal maturation finally ends the patients are then able to reach their genetic target height.…”

Idiopathic short stature: Management and growth hormone treatment

“…Doses ranging from 50 to 200 mg IM monthly have positive effects on growth velocity without unduly advancing the bone age, with no detrimental effect on adult height, except at the high doses [86]. Interestingly studies have shown that 6 months of testosterone treatment does not affect the tempo of puberty [87].…”

Growth and Timing of Puberty: Reciprocal Effects

“…This suggests that the genetic factors account for a reduced adult stature in many of those patients. In 3 studies, the administration of long-acting esters of testosterone using dosages of 200 mg/month or more was shown to result in some pos sible reduction (mean: 2-5 cm) of adult height when compared to untreated patients [22,23,25], In contrast, lower dosages of testosterone given for up to 1 year did not affect final height which was slightly above that of untreated patients [23. 24].…”