CLINICAL AND BIOCHEMICAL CORRELATES IN IDIOPATHIC DELAYED PUBERTY (IDP)

Abstract

Thirty five boys with idiopathic delayed puberty (IDP, defined as onset of testicular enlargement after age 14) were evaluated by pubertal staging, growth velocity (GV), bone age (BA), FSH, LH and testosterone (T) measurements. Pubertal staging was based on testicular measurement: length 2.5 cm =P1, 2.5-3.2 cm =P2, 3.3-4 cm =P3, 4.1-4.4 cm = P4, > 4.5 cm =P5. Testosterone, FSH and LH were measured by RIA, BA by the method of Gruelich and Pyle. Ages ranged from 14 to 18 years, One boy was at stage P1, 8 boys at P2, 18 boys at P3 and 8 boys at P4. Mean age/BA were not different among the P2, P3 and P4 groups 15.2/12.5, 15.1/12.6 and 15.8/13 respectively. Mean GV in P2 and P3 boys was not significantly different, 3.8 ± .36 cm/yr vs 4.8 ± .36, p>.05. GV in P4 group was 6 ± .86 cm/yr, significantly greater than P2 group P < 0.05, but not P3 group. Mean FSH/LH for P2, P3 and P4 groups were similar 4/7.4, 3.5/8.7 and 4/7.0 mIu/ml respectively. Mean T concentration in P2 group 65.6 ± 23 and P3 group 83 ± 21 ng/dl were not significantly different. T in P4 group 211.4 ± 37.7 ng/dl was significantly greater than the P2 and P3 groups. There was no correlation between GV vs BA, T vs BA, or T vs GV. The findings imply the heterogeneity of IDP. Pubertal development and T rise are distinct from general population. The clinical implications of such findings are in anticipatory guidance and prediction of pubertal events in IDP.