Soliman A T, Khadir M M, Asfour M
Department of Pediatrics, University of Alexandria, College of Medicine, Egypt.
Metabolism. 1995 Aug;44(8):1013-5. doi: 10.1016/0026-0495(95)90098-5.
Administration of androgens to adolescent boys with constitutional delay in growth has been highly controversial. One hundred forty-eight adolescent boys with constitutional delay of growth and puberty with a mean age of 14.3 +/- 0.7 years were treated with testosterone enanthate 100 mg intramuscularly each month for 6 months. Growth parameters, sexual maturation, and circulating concentrations of testosterone and insulin-like growth factor-I (IGF-I) were compared with those for 50 age-matched adolescent boys with constitutional delay of growth and puberty with a mean age of 14.1 +/- 0.9 years who did not receive any treatment. The mean height growth velocity, height standard deviation score, weight gain, and IGF-I concentration were significantly greater in the treatment group after 1 year of follow-up evaluation. The advancement in bone age equaled that in chronologic age in the treatment group, with no significant change in the bone age to chronologic age ratio (BA/CA) before versus after therapy. All subjects in the treatment group had clearly entered puberty by the end of 1 year. Testicular size increased significantly in the treatment group and they had significantly higher serum testosterone concentrations 6 months after the end of testosterone therapy as compared with the control group, denoting activation of the hypothalamic-pituitary testicular axis. All subjects in the treatment group were psychologically satisfied with the enhanced growth and increased muscle mass, versus only 40% of those in the control group. In conclusion, our regimen appears to be efficacious and safe for treatment of boys with constitutional delay of growth and puberty and has no deleterious effect on skeletal age.
对生长发育迟缓的青春期男孩使用雄激素一直存在很大争议。148名生长发育和青春期迟缓的青春期男孩，平均年龄为14.3±0.7岁，每月接受100mg庚酸睾酮肌肉注射，共治疗6个月。将这些男孩的生长参数、性成熟情况以及睾酮和胰岛素样生长因子-I（IGF-I）的循环浓度，与50名年龄匹配、生长发育和青春期迟缓且平均年龄为14.1±0.9岁、未接受任何治疗的青春期男孩进行比较。经过1年的随访评估，治疗组的平均身高增长速度、身高标准差评分、体重增加以及IGF-I浓度均显著更高。治疗组的骨龄进展与实际年龄进展相当，治疗前后骨龄与实际年龄之比（BA/CA）无显著变化。治疗组所有受试者在1年末均已明显进入青春期。治疗组的睾丸大小显著增加，与对照组相比，在睾酮治疗结束6个月后，他们的血清睾酮浓度显著更高，表明下丘脑-垂体-睾丸轴被激活。治疗组所有受试者对身高增长加快和肌肉量增加在心理上感到满意，而对照组只有40%的人有此感受。总之，我们的治疗方案对于治疗生长发育和青春期迟缓的男孩似乎有效且安全，对骨龄没有不良影响。
