Le normogramme pubertaire chez le garçon: un outil diagnostique dynamique pour l'évaluation des retards pubertaires

A. Juul*^a

^a The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhague, DANEMARK

* Anders.Juul@regionh.dk

Few data exist on the diagnostic criteria, and on the effects of puberty induction, in boys with constitutional delay in growth and puberty (CDGP).

We therefore aimed at developing puberty nomograms based on Danish boys with normal pubertal development. Furthermore, we evaluated the different diagnostic criteria and the effect of oral testosterone undecanoate (TU) in boys with CDGP.

Participants One hundred and sixty-four (36%) boys evaluated for CDGP were excluded due to missing data, reclassification, or associated comorbidities, yielding 287 (64%) eligible for analysis.

Results Seventy-eight (27%) of the 287 boys had delayed pubertal onset according to the classical criteria, whereas 173 (60%) of the 287 boys had impaired pubertal progression according to the puberty nomogram. Ninety-six (56%) of these 173 boys were treated with oral TU for 0.8 years (0.5;1.3) [median (25th;75th percentiles)], which resulted in beneficial effects on pubertal progression. Height increased from -1.9 SD (-2.5;-1.2) to -1.5 SD (-2.1;0.7) (p<0.001), and PAH increased from 172.3 cm (170.3;182.8) to 178.1 cm (171.4;191.7) (p=0.001) following one year of oral TU treatment.

Conclusions The puberty nomogram evaluates both delayed pubertal onset as well as delayed pubertal progression and allows separation of normal versus abnormal pubertal development. Oral TU treatment was followed by pubertal induction and progression and short-term growth without compromising final height.

L’auteur n’a pas transmis de déclaration de conflit d’intérêt.