Boys Of Short Stature Research Articles

Penile Length of Prepubertal Children in Surabaya

Background: Early recognition of phallic size abnormalities is essential to identify underlying endocrine and genetic disorders. Parents are concerned regarding their son’s penis length, especially obese and short-stature boys. This study aimed to investigate the factors of penile length in prepubertal boys aged 9-11 in Surabaya.Methods: A cross-sectional analytic observational study was conducted between October and November 2021 during the community services program of the Andrology Study Program, Universitas Airlangga. One hundred forty-eight healthy boys aged 9-11 years were enrolled in this study. Penile parameters and anthropometric measures were recorded. Data were analyzed with Spearman Rho’s formula to correlate the variables studied.Results: The average penile lengths and penile circumference of the penis were 6.3±1.4 and 5.2±1.0 cm, respectively. This study found two boys with micropenis (1.35%) with normal and overweight body mass index (BMI). The penile length was positively correlated with height but not with BMI.Conclusion: Androgen and growth hormones significantly influence penile length. Children with abnormal BMI tend to have smaller penile sizes, associated with increasing androgen aromatization.

Testicular function in boys previously treated with recombinant-human growth hormone for non-growth hormone-deficient short stature

Data on the effects of recombinant human GH (hGH) therapy during male puberty on future testis function are still inconclusive. The aim of this study was to investigate the long-term effects of recombinant hGH treatment on reproductive function in non-GH-deficient short stature boys. Eight boys with non-GH-deficient short stature, affected by constitutional delay of puberty or idiopathic short stature, were retrospectively studied after recombinant-hGH treatment to verify gonadal development, hormone production and semen quality. Auxological data, endocrinological/ andrological parameters and laboratory evaluation (GH, IGF-I, FSH, LH, testosterone, inhibin B) were assessed before treatment; after completion of pubertal development, the same parameters plus SHBG levels were evaluated and a seminal fluid examination was conducted (ejaculate volume, pH, sperm concentration, total sperm count, forward and total motility, morphology). All patients showed normal testicular volume at the final pubertal stage, with regular androgenization. Hormonal levels were within the normal adult range in all boys. Considering the immature reproductive system of these patients in comparison with adults, semen parameters (sperm count, motility, and morphology) were within almost normal limits, except in one patient. Although patients showed the wide fluctuation of semen values frequently observed at the end of puberty, the hypophysis-gonadal axis hormones were in the normal range in all adolescents. Pathological measurements of some seminal parameters were found in one patient only. This study suggests that recombinant hGH treatment has no detrimental effects on the development and maturation of male gonadal function in non- GH deficient short stature young patients.

Psychological functioning in boys of short stature: effects of different levels of growth hormone secretion

Aim: To examine the relationship between growth hormone (GH) and psychological functioning, especially self‐perception and well‐being, in 60 prepubertal boys of short stature with a wide range of GH levels. Methods: A comparison was made of the well‐being and self‐perception of children with GH insufficiency, children with idiopathic short stature (ISS), a normative sample and healthy boys with normal stature. Results: Children with GH insufficiency had a more negative perception of their own physical appearance than the normative sample. They perceived themselves as more alert but also more inhibited than both the children with ISS and the healthy boys with normal stature. In comparison with the healthy boys with normal stature they perceived themselves as having more stability. The parents of the boys with GH insufficiency also perceived their children as being more stable compared with how the parents of boys with ISS perceived their children. To elucidate the effects of GH on psychological functioning a multiple regression analysis was performed. Conclusion: The lower the levels of GH the more inhibited were the boys of short stature, as perceived both by themselves and by their parents. The boys with GH insufficiency had a more negative perception of their physical appearance than the normative sample.

Normal Urinary Growth Hormone Measurement in Short-Stature Early Pubertal Boys May Help to Exclude Growth Hormone Deficiency

To determine whether urinary growth hormone (U-GH) measurement is a useful indicator of subsequent growth rate in young boys. We assessed the U-GH concentrations in five early pubertal boys with constitutional short stature (CSS) who were referred to a growth clinic and compared the results with those obtained in normal children and in children with GH deficiency. In the five early pubertal short-stature boys, the U-GH concentration ranged from 3.7 to 9.7 ng/night and, despite their blunted plasma GH responses to two different pharmacologic tests (peak plasma GH <7 ng/mL), proved to be a useful indicator of their subsequent normal growth rate. The U-GH was 2.2 +/- 0.2 and 4.1 +/- 0.5 ng/night in 38 normal prepubertal and pubertal children, respectively, 2.4 +/- 0.2 ng/night in 13 subjects with CSS, and 1.1 +/- 0.2 ng/night in 16 GH-deficient short-stature children. We may speculate that 24-hour GH secretion and possibly U-GH normalize sooner than do responses to provocative testing as sex steroids appear in early pubertal constitutional short-stature boys. From a practical standpoint, it seems that U-GH values higher than 2.6 ng/night (mean + SE value for subjects with CSS) in such patients may justify postponement of the pharmacologic tests and waiting for growth during the subsequent year.

Short Stature: A Psychosocial Burden Requiring Growth Hormone Therapy?

Changes in the diagnosis of endocrine-based growth disorders and the advent of biosynthetic growth hormone have altered the long-standing policy of treating only those individuals with "classic" growth hormone deficiency. One justification for treating short children is to improve their psychosocial adaptation. The present investigation assessed the positive and negative behavioral adaptation, self-perceptions of domain-specific competencies, and global self-worth of a large, diagnostically heterogeneous sample of children and adolescents referred to pediatric endocrinologists for a growth evaluation. All patients seen in a pediatric endocrine clinic (180 boys and 78 girls; 4 to 18 years) with a height at the fifth percentile or lower were included. Parents of all participating children completed the Child Behavior Checklist. Patients 8 years and older completed the Self-Perception Profile and those 11 years and older, in addition, completed the Youth Self Report. Short-stature (SS) subjects were compared with normative and psychiatric samples. The SS boys were described by parents as being significantly less socially competent and showing more behavioral and emotional problems than a normative sample selected for mental health. However, they were significantly more socially competent and showed fewer psychopathologic symptoms than a psychiatric referred sample of comparable age. The SS boys described themselves as less socially active but did not report more behavior disturbance than the normative sample. The SS boys' self-perceptions of domain-specific competencies and global self-worth were comparable to a normative comparison group with the exception that older subjects (13 years or older) described their athletic abilities more positively and their work competence more negatively. The SS girls were, with few exceptions, indistinguishable from the normal comparison groups on both parent- and self-report measures of social competency and behavior disturbance. Younger SS girls (ages 8 to 12 years) described their athletic competence and behavioral conduct more positively than the comparison group on the self-esteem questionnaire. Patient height deficit was unrelated to scores on the three questionnaires. Finally, no statistically significant differences in psychosocial functioning were detected between children with "normal-variant" SS and those with pathologic growth disorders. SS and those with pathologic growth disorders. Short-stature girls show more adaptive psychosocial functioning than SS boys. In either sex, SS does not appear to be associated with clinically significant psychosocial morbidity. Severity of the height deficit does not correlate with the level of behavioral adaptation. These observations challenge the justification of providing growth hormone therapy for all short children to improve their psychosocial functioning.

Plasma growth hormone secretion during constant growth hormone-releasing factor infusion.

Synthetic human pancreatic growth hormone-releasing factor (hpGRF-44) was infused intravenously at a constant rate of 2.5 micrograms/min for 180 minutes in 3 normal boys of short stature. Plasma GH levels reached a peak at 60-120 min with a mean value (+/- SEM) of 69.1 +/- 14.3 ng/ml, and then, declined gradually in spite of continuous hpGRF-44 infusion up to 180 minutes. Similarly, constant infusion of hpGRF-44 at a rate of 2.5 micrograms/min in 5 normal but short boys for 90 minutes, together with an iv bolus injection of hpGRF-44 (2 micrograms/kg) administered at 0 and 90 minutes, elicited a prompt rise in plasma GH 15-30 minutes after the first bolus but no significant elevation of GH was observed after the second bolus. In contrast, when two iv bolus injections of hpGRF-44 (2 micrograms/kg) were given in 4 normal boys with short stature at 0 and 90 minutes, respectively, significant elevation of plasma GH was found after each bolus. These results suggest that under constant infusion of GRF the pituitary experiences a down-regulation after the initial peak of GH response, possibly due to desensitization to GRF.