The effect of pubertal delay on adult height in men with isolated hypogonadotropic hypogonadism.

Abstract

To determine whether delay of puberty alters adult height, we retrospectively evaluated the adult height of 41 patients who met rigorous criteria for the diagnosis of isolated hypogonadotropic hypogonadism. The adult height of these patients was compared with the mean height of normal American men at age 18 in the 1979 National Center for Health Statistics survey and with the mean adult height of 50 male normal volunteers who had been studied on the same wards as the patients with hypogonadotropic hypogonadism. The mean adult height of the men with isolated hypogonadotropic hypogonadism was 179.7 cm, which exceeded the height of the 50 control subjects and the normal American men (both 176.8 cm) by 2.9 cm (P less than 0.05 and P less than 0.006, respectively). The mean age at treatment to induce puberty was 20.0 yr, which corresponded to a mean delay in the onset of puberty of more than 8 yr relative to normal males. The final height of the men with hypogonadotropic hypogonadism correlated significantly with the duration of pubertal delay (r = 0.32, P = 0.04). Most of the enhanced mean adult height of the patients with isolated hypogonadotropic hypogonadism was attributable to those patients in whom treatment to induce puberty had been delayed to age 18 or greater. The mean adult height of these patients was 182.4 cm, or 5.6 cm greater than the mean height of the 50 controls or of normal American men (P less than 0.001). The mean adult height of patients whose treatment began between 10 and 17 yr of age was 175.0 cm, which did not differ significantly from that of normal men. We conclude that prolonged delay of puberty (6 or more yr) in men with isolated hypogonadotropic hypogonadism is associated with a modest increase (approximately 5 cm) of adult height.

Childhood growth in boys with congenital hypogonadotropic hypogonadism

“…During childhood, boys with CHH experienced relatively normal childhood growth. Similarly, previous studies have described unremarkable childhood growth in patients with CHH (11)(12)(13)(14)(15)(16). This growth phase is mainly GH/IGF axis dependent, and our results support the concept that growth during this period of life is not significantly modified by testicular androgens, although some gonadotropin secretion is detected already in 5-y-old-boys (28).…”

“…Subjects with CHH typically suffer from low sex steroid levels during minipuberty (9,10), and thereby CHH provides a meaningful model to study the relationship between early sex steroid deficiency and growth. Although somatic growth and final heights of patients with CHH have been characterized before (11)(12)(13)(14)(15)(16), these studies stem from the era when no comprehensive knowledge on molecular genetics of CHH was available. Previous reports show, however, that subjects with CHH appear to grow relatively normally during childhood (11)(12)(13)(14)(15)(16), and expectedly display a decrease in growth rate during adolescence due to the absence of pubertal growth spurt.…”

Non-syndromic congenital hypogonadotropic hypogonadism: clinical presentation and genotype–phenotype relationships

“…All patients with CHH have normal statural growth during childhood and, despite the absence of the pubertal growth spurt, statural retardation is very rarely a presenting symptom (31). On the contrary, the absence of long-bone epiphyseal closure explains these patients' frequent eunuchoid aspect and relative tallness.…”

“…On the contrary, the absence of long-bone epiphyseal closure explains these patients' frequent eunuchoid aspect and relative tallness. Retarded bone maturation, osteopenia, and osteoporosis are frequent when the gonadotropin deficiency is discovered in adulthood (31)(32)(33)(34).…”

Can we increase adolescent growth?

“…that short treatments with GnRH agonists led to no or clinically insignificant adult height gains (19,22,23). This is reminiscent of the increased adult height of patients with hypogonadism, only if untreated to the age of 20 years (24). Similarly, in males with estrogen receptor or aromatase deficiency, height is normal or low around the age of puberty in the absence of a growth spurt.…”