TESTOSTERONE TREATMENT IN ADOLESCENT BOYS WITH CONSTITUTIONAL DELAY OF GROWTH AND DEVELOPMENT

Administration of androgens to adolescent boys with constitutional del ay in growth has been highly controversial. One hundred forty-eight ad olescent boys with constitutional delay of growth and puberty with a m ean age of 14.3 +/- 0.7 years were treated with testosterone enanthate 100 mg intramuscularly each month for 6 months. Growth parameters, se xual maturation, and circulating concentrations of testosterone and in sulin like growth factor-I (IGF-I) were compared with those for 50 age -matched adolescent boys with constitutional delay of growth and puber ty with a mean age of 14.1 +/- 0.9 years who did not receive any treat ment. The mean height growth velocity, height standard deviation score , weight gain, and IGF-I concentration were significantly greater in t he treatment group after 1 year of follow-up evaluation. The advanceme nt in bone age equaled that in chronologic age in the treatment group, with no significant change in the bone age to chronologic age ratio ( BA/CA) before versus after therapy. All subjects in the treatment grou p had clearly entered puberty by the end of 1 year. Testicular size in creased significantly in the treatment group and they had significantl y higher serum testosterone concentrations 6 months after the end of t estosterone therapy as compared with the control group, denoting activ ation of the hypothalamic-pituitary testicular axis. All subjects in t he treatment group were psychologically satisfied with the enhanced gr owth and increased muscle mass, versus only 40% of those in the contro l group. In conclusion, our regimen appears to be efficacious and safe for treatment of boys with constitutional delay of growth and puberty and has no deleterious effect on skeletal age. Copyright (C) 1995 by W.B. Saunders Company