Determinants of Pubertal Growth Spurt in Constitutional Delay of Growth and Puberty in Boys Treated With Testosterone.

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BACKGROUND: Constitutional delay of growth and puberty (CDGP) is the most common cause of short stature and delayed puberty in children. Little is known about the changes in sex steroid and insulin like growth factor-1 (IGF-1) concentrations, body mass index (BMI), and growth velocity (GV) after testosterone therapy for CDGP. CASE PRESENTATION: Retrospective chart review of 16 boys with CDGP treated with six monthly doses of testosterone cypionate 50 mg was carried out. Data on weight, BMI, height, GV, IGF-1, testosterone level and bone age radiographs were collected prior to testosterone treatment, six months and one year after the last testosterone injection. At six months and one year from last dose of testosterone, the mean height, weight, GV, mean IGF-1 and testosterone levels improved from baseline. There was a positive correlation between testosterone and GV (r= 0.74, p-value= 0.008) six months after the last testosterone injection. CONCLUSION: At six months and one year after the last testosterone injection, the weight, BMI, growth velocity, IGF-1 concentrations and testosterone levels were higher than at baseline, and puberty progressed when compared to baseline. Testosterone levels six months after completion of testosterone cypionate were positively correlated with growth velocity confirming the effect of sex steroids in pubertal growth.

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