Differing growth, weight patterns distinguish delayed puberty in boys

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Source :- healio.com

Boys with constitutional delay of growth and puberty display hallmark changes in height and body weight during the first 5 years of life that distinguish the condition from other growth disorders, such as hypogonadotropic hypogonadism, according to findings published in Clinical Endocrinology.

Thomas Reinehr
“Constitutional delay of growth and puberty (CDGP) is characterized by height and weight deflection during the first 2 years of life,” Thomas Reinehr, MD, head of the department of pediatric endocrinology, diabetes and nutrition medicine at the Vestische Children and Youth Clinic, University of Witten, Germany, told Endocrine Today. “At adult age, boys with CDGP have a near-target height and a normal weight status. In contrast, hypogonadotropic hypogonadism is characterized by an increase of weight and a deflection of height, not during the first years of life, but at pubertal age.”

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In a retrospective study, Reinehr and colleagues analyzed longitudinal height and weight data in the first 5 years of life in 54 boys with CDGP presenting between 1999 and 2013 at Vestische Children’s and Adolescent Hospital, the University of Witten-Herdecke or at the Children’s Hospital at the University of Tubingen (mean age, 14 years), as well as height and weight data from eight boys with hypogonadotropic hypogonadism (mean age, 14 years).

In boys with CDGP, the researchers observed that height-standard deviation scores (SDS) decreased (mean change, –0.94; P < .001) between birth and age 2 years, as did BMI-SDS (mean change, –0.38; P < 0.001) during the same period. From age 2 to 5 years, boys with CDGP did not experience changes in height-SDS or BMI-SDS; however, between pubertal and adult age, height-SDS increased (mean change, 1.49; P < .001), as did BMI-SDS (mean change, 0.91; P < .001), according to researchers.

In contrast, among boys with hypogonadotropic hypogonadism, height-SDS and BMI-SDS did not change in the first 5 years of life, the researchers wrote. From age 5 years to puberty, height-SDS decreased (mean change, –1.39; P = .018); however, there were no changes observed in BMI-SDS. At pubertal age, BMI-SDS was higher in boys with hypogonadotropic hypogonadism compared with boys with CDGP (P = .001).

“These different patterns of growth and weight are helpful to distinguish CDGP from hypogonadotropic hypogonadism and other diseases with growth disturbances, such as growth hormone deficiency, probably helping to avoid unnecessary test and procedures,” Reinehr said. “Comparing growth in the first years of life of children with other diseases leading to short stature, such as growth hormone deficiency, to the growth patterns of constitutional delay of growth and puberty, will help us to decide which patients need growth hormone stimulation testing.” – by Regina Schaffer

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