Comparison of long-term height and pubertal outcomes in boys with delayed puberty due to constitutional delay in growth and puberty (CDGP) and isolated hypogonadotropic hypogonadism (iHH)

Background and objective: Study aims to evaluate the pubertal development and final height(FH) outcome in patients presented with delayed puberty due to hypogonadotropic hypogonadism(HH) and constitutional delay in growth and puberty(CDGP). Design and participants: The hospital files of 1654 boys older than 14 years of age who were evaluated for delayed puberty between 01.01.2002 and 01.04.2022 in Hacettepe University İhsan Doğramacı Children's Hospital Pediatric Endocrinology Department were reviewed retrospectively. 191 patients who met the inclusion criteria were included in the study. Results: The mean age of admission was 14.6±0.9 years. Of those, 149 patients had CDGP and 42 patients had HH. The mean FH-SDS of patients with HH(-0.09±1.0) was higher than those with CDGP(-0.64±0.91)(p=0.003). In total, 118 out of 128 patients(92.2%) with CDGP and 36 out of 39 patients(92.3%) with HH had reached an FH consistent with their target height(TH). There was no statistically significant difference between the FH-SDS of patients with CDGP who received testosterone therapy for induction of puberty and those who did not receive(-0.46±0.97 SD vs. -0.74±0.87 SD; p=0.094). Conclusion: Individuals presented with delayed puberty due to both CDGP and HH have reached an FH consistent with their TH to a large extent. Patients with HH had a higher presenting and final height than those with CDGP, which was attributed to the higher TH. Induction of puberty with testosterone in boys with CDGP seems not to have a clinically meaningful impact on the FH and long-term pubertal progression.