Secondary sexual development of Cape coloured boys following kwashiorkor

This report describes the secondary sexual development of 78 Cape Coloured male ex-kwashiorkor patients and 53 male controls. All patients were originally seen between 5 months and 4 years 4 months of age, treated and then followed up for 15 years after discharge. Age at peak height velocity (PHV) was available for 23 ex-patients and 15 controls. Maximum likelihood estimates of the mean age at entry to each pubertal stage were made and age at PHV was obtained by fitting a non-linear growth function to the data for each subject with appropriate serial height records. No significant differences were observed between ex-patients and controls for either the sequence of pubertal events or for the age of entry to each stage. When compared to a sample of normal British boys the Cape Coloured sample exhibited significant delay for ages at entry to all pubertal stages with differences ranging from 0.84 years for PH2 to 1.94 years for PH5. It is suggested that adrenal androgens play a major role in delaying secondary sexual development during chronic malnutrition and that the anterior pituitary's response to such conditions is to selectively delay pubertal status.