Clinical and hormonal predictors of start pubertyin boys with constitutional delay of puberty

• Brzhezinskaya Lyubov’ B.

Abstract

The aim - to examine the cLinicaL and hormonaL predictors of start puberty in boys with constitutionaL deLay of puberty (CDP).

Material and methods. The study incLuded 42 boys with CDP. At the first visit in 14.5+0.7 yearswe evaLuated anthropometric indicators, bone age, testicuLar voLume and hormonaL status. At the second visit after 0.9 (0.8; 1.1) years, we evaLuated stage of sexuaL deveLopmenton the Tanner scaLe. The patients were divided into two groups: Tanner I (n=9), Tanner ≥II (n=33).

Results. At the first visit aLL patient shad the same height, weight, boneage and TSH, free T₄, proLactin, IGF-1, DHEAS, cortisoL, insuLin, LH, FSH, estradioL, SHBG. However, in boys with Tanner ≥II at the first visit, height was no different from target height, testicuLar voLumes was much more, testosterone, inhibin В were significantLy higher and anti-muLLerian hormone was significantLy Lower then in boys with Tanner I. The most informative predictors of start pubertaL in boys with CDP during the first year were: testosterone >0.9 nmoL/L (sensitivity 81.3%, specificity 67%), inhibin В >143 pg/mL (sensitivity 57%, specificity 100%), testicuLar voLume >1.7 cm³ (sensitivity 75.8%, specificity 100%) and the combination of inhibin В >143 pg/mL with testicuLar voLume >1.7 cm³ (sensitivity 88%, specificity 100%).

Conclusion. The combination of inhibin B>143 pg/mL with testicuLar voLume >1.7 cm³ had the best sensitivity (88%) and specificity (100%) in predicting the start puberty during the first year in boys with constitutionaL deLay of puberty.

Keywords: deLay of puberty in boys, hypogonadotropic hypogonadism, inhibin, anti-muLLerian hormone, testosterone, testicuLar voLume

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