Normal volumetric bone mineral density and bone turnover in young men withhistories of constitutional delay of puberty

It has been suggested that an appropriate timing of puberty is necessary fo r normal bone mineral density (BMD) acquisition, which may not be achievabl e in children with constitutional delay of puberty (CDP). To assess the eff ect of pubertal delay on BMD, me measured areal BMD (aBMD) at lumbar spine, by dual-energy x-ray absorptiometry (DEXA), in a group of patients with CD P (n = 21; mean age, 21.8 +/- 1.7 yr) at final height and in healthy contro ls (n = 12; mean age, 19.3 +/- 1.3 yr). A subset of seven patients (group a ) were untreated, whereas six subjects (group b) had received im testostero ne depot (100 mg/month, for 6-12 months) and 8 boys (group c) oral oxandrol one (1.25-2.5 mg/daily, for 6-28 months) for their pubertal delay. Volumetr ic BMD (vBMD) was calculated from DEXA measurements. aBMD was reduced in pa tients with CDP (1.101 +/- 0.134 g/cm(2)), in comparison with controls (1.2 22 +/- 0.091 g/cm(2); P < 0.009); no significant differences were found amo ng the groups (group a, 1.089 +/- 0.133 g/cm(2); group b, 1.111 +/- 0.118 g /cm(2); group c, 1.103 +/- 0.160 g/cm(2)). vBMD was not significantly diffe rent in patients with CDP (0.327 +/- 0.021 g/cm(3)) and in controls (0.337 +/- 0.017 g/cm(3); P = not significant); no significant differences were fo und among the groups (group a, 0.326 +/- 0.016 g/cm(3); group b, 0.332 +/- 0.022 g/cm(3); group c, 0.330 +/- 0.021 g/cm(3)). No differences were found in mineral metabolism and in bone markers between patients and controls; p atients did not report an increased fracture rate, compared with controls. Our data indicate that: 1) men with CDP have normal vBMD; 2) the reduced aB MD may he the result of uncritical use of DEXA measurements in subjects wit h altered growth pattern; and 3) androgen administration during pubertal ye ars did not improve BMD in young men with a history of CDP.