Clinical and hormonal characteristic of constitutional delay ofpuberty in boys with obesity

• Brzhezinskaya Lyubov’ B.
• Lyubov’ N. Samsonova
• Oleg Yu. Latyshev
• Goar F. Okminyan
• Elena V. Kiseleva
• Elvira P. Kasatkina

Abstract

To examin the anthropometric and hormonal characteristic of constitutional delay of puberty (CDP) in boys with overweight/obesity.

Methods. The study included 89 boys aged 14.5+0.8 years with CDP. The boys with deficiency weight were excluded from the study. The other patients were divided into two groups: the main group consisted of 30 boys with overweight/obesity and the comparison group - 47 boys with normal weight. We evaluated BMI, height, bone age, testicular volume, inhibin В, anti-Mullerian hormone, LH, FSH, total testosterone, SHBG, free-androgen index, estradiol, DHEA-s, IGF-1, insulin, cortisol, TSH, free Т₄, prolactin.

Results. The boys with CDP and overweight/obesity in contrast to boys with normal weight were sig­nificantly higher (Ме Ht-SDS -0.6 vs -1.9, p=0.00009), pathological delay height was significantly lesser (6.6% vs 46.8%, p=0.0004), bone age was much more (Ме -1.7 vs -2.9, p=0.0003), pathological delay of bone age was significantly lesser (20% vs 68.9%, p=0.0002), hormones were significantly higher, such as DHEAS (Ме 4.4 vs 3.1 nmol/l, p=0.05), insulin (Ме 9.2 vs 4 mkEd/ml, p=0,00002), hormones were significantly lower, such as cortisol (Ме 270 vs 397 nmol/l, p=0.03) SHBG (Ме 52.8 vs 93.5 mkEd/ml, p=0.0001), total testoster­one (Ме 1 vs 1.9 nmol/l, p=0.009) and HCG stimulated testosterone (Ме 12.7 vs 18.1 nmol/l, p=0.02),and the same indicator in two groups: free-androgen index (Me 3.3 vs 2.4 %, p=0.4). There were statistically sig­nificant negative correlations between BMI-SDS and SHBG (r=-0.7, p=0.014) and between insulin and SHBG (r=-0.4, p=0.009).

Conclusions. In contrast to boys with normal weight, the adolescents with overweight/obesity and consti­tutional delay of puberty have more height and more bone age that connected with high levels of insulin and DHEA-S. The boys with constitutional delay of puberty and overweight/obesityhave insulin-induced reduction SHBG and total testosterone.

Keywords:obesity, delay of puberty in boys, testosterone, insulin, bone age, SHBG, free-androgen index

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