Progressive Deceleration in Growth as an Early Sign of Delayed Puberty in Boys

Abstract

Objective: To describe the prepubertal growth pattern in boys with delayed puberty. Methods: Growth curves for height and height velocity covering the age range 4–14 years were constructed on the basis of retrospectively obtained data in 85 boys with delayed puberty, who attained a normal final height. Results: Between the age of 4 and 14 years the height in this cohort progressively deviated from the normal reference. At the age of 4 years, the height SDS was already significantly lower (median –0.8; p < 0.001) and progressively diminished during childhood, resulting in a median height SDS of –1.1 at the age of 12 years (p < 0.001). The median final height of this cohort (–0.4) was not different from their target height (–0.2). The degree of deceleration in growth during childhood was not determined by birth weight or birth height and did not influence final height. The decline of the height velocity with age in this group of boys with delayed puberty was significantly smaller (p < 0.001) than predicted by the model of Rikken and Wit. Conclusion: Late-maturing boys often show a prepubertal deceleration in growth that starts at an early age but that does not affect final height.

Progressive Reduction of Relative Height in Childhood Predicts Adult Stature below Target Height in Boys with Constitutional Delay of Growth and Puberty

“…In a study of 49 CDGP patients, 3 boys who failed to reach adult stature within TH (FH from 8.6 to 11 cm below TH) were the smallest at diagnosis [8]. Two previous studies have demonstrated that height SD reduction already after 4 or 6 years of age does not adversely affect FH [4, 5]. In both of these studies, however, the reduction of height SD before puberty was smaller and occurred later than in our study, and no comparison with boys who did not have an early childhood height SD reduction was made.…”

“…When such adolescents are compared with adolescents with normal timing of puberty, this pattern of growth will inevitably cause a reduction of relative height (standard deviations, SDs, in height) in pubertal years [1,2,3]. At least in a subgroup of CDGP subjects, the reduction in height SDs starts already early in childhood, well before puberty [4, 5]. Although boys with CDGP may be short during pubertal years, many will achieve a final adult height (FH) that is normal compared with the general population [5,6,7,8,9].…”

Boys with a Simple Delayed Puberty Reach Their Target Height

“…There is still no consensus on the issue whether boys with a delayed puberty reach a final height appropriate for their target height [1, 2,7,8,9,10,11,12,13]. Most authors found that boys with pubertal delay reach a final height appropriate for their parental centiles, while others claim final height was significantly below target height [6,7,8,9,10,11,12,13].…”

“…Most authors found that boys with pubertal delay reach a final height appropriate for their parental centiles, while others claim final height was significantly below target height [6,7,8,9,10,11,12,13]. This discrepancy can partially be explained by the fact that most studied groups were a mixture of boys with a physiological delayed puberty with a normal height potential and boys with genetic short stature combined with pubertal delay.…”

Estudo do gene GPR54 nos distúrbios puberais centrais idiopáticos

“…Total inositol phosphate and phosphorylation of extracellular signal-regulated kinase were measured at various points after stimulation with increasing levels of kisspeptin. 15 (For details, see the Methods section of the Supplementary Appendix.) R e sult s…”