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Management of boys with short stature and delayed puberty

A C Couto-Silva1, C Trivin, L Adan

  • 1Université René Descartes Paris V and Unité d'Endocrinologie Pédiatrique, Hôpital Bicêtre, Assistance Publique-Hopitaux de Paris, France.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|October 5, 2005
PubMed

Insights

Testosterone priming improves growth hormone (GH) secretion in boys with short stature and delayed puberty. The number of testosterone doses impacts priming quality, and careful assessment is crucial for treatment decisions.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Pubertal Development

Background:

  • Short stature and delayed puberty are common concerns in pediatric endocrinology.
  • Accurate assessment of growth hormone (GH) secretion is vital for guiding treatment decisions.
  • Testosterone priming is a potential strategy to enhance GH assessment and stimulate growth.

Purpose of the Study:

  • To review the management of boys with short stature and delayed puberty.
  • To evaluate the efficacy of testosterone priming protocols for growth hormone (GH) testing.
  • To analyze factors influencing final height in this cohort.

Main Methods:

  • Studied 148 boys over 14 years old with height < -2 SDS and constitutional delayed puberty.
  • Assessed growth hormone (GH) secretion via arginine-insulin tolerance tests with and without testosterone priming.
  • Evaluated final height in 80 boys and correlated with GH secretion and IGF-I levels.

Main Results:

  • Testosterone priming improved GH peak response in stimulated tests compared to no priming (25% vs. 41% low GH peak).
  • Higher testosterone doses (4x100mg) showed a trend towards better GH response than lower doses (2x100mg).
  • Final height was similar regardless of GH peak or testosterone treatment, with a significant proportion falling short of target height.

Conclusions:

  • Nocturnal GH secretion is a more reliable indicator than stimulated GH peaks.
  • The quality of testosterone priming is dose-dependent.
  • Key management aspects include excluding underlying diseases and judiciously initiating testosterone therapy.
Abstract

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