Antoniazzi F, Zamboni G, Tatò L
Clinica Pediatrica, Università di Verona, Italia.
Pediatr Med Chir. 1996 Jan-Feb;18(1):27-31.
Delayed puberty can be defined as the absence of any signs of puberty in subjects that have attained an age at the upper limit (+2DS) for the onset of puberty, that means 13 years in girls and 14 years in boys. The causes of delayed puberty can be classified into three groups, functional temporary impairment in gonadotropin and sex steroid secretion (most frequently constitutional delay of puberty), hypothalamo-pituitary failure with deficiency in gonadotropin secretion, primary gonadal failure with increased gonadotropin levels. The Authors discuss about etiology, diagnostic testing and therapeutic approach in these conditions. The majority of children with delayed puberty are males that have only a constitutional delay of growth and puberty. It is difficult, in teenage years, to distinguish this common and benign condition from true gonadotropin deficiency, in spite of the variety of endocrine tests developed for this purpose. Individuals with constitutional delayed puberty with a bone age greater than 11.5 years, show after triptorelin stimulation an increase in LH capable of distinguishing them from patients with gonadotropin deficiency. In our opinion this could be an important screening test to exclude gonadotropin deficiency in boys with delayed puberty.
已达到青春期开始年龄上限（+2标准差）的个体仍未出现任何青春期迹象，即女孩13岁、男孩14岁。青春期延迟的原因可分为三类：促性腺激素和性类固醇分泌的功能性暂时损害（最常见的是体质性青春期延迟）、促性腺激素分泌不足的下丘脑 - 垂体功能衰竭、促性腺激素水平升高的原发性性腺功能衰竭。作者讨论了这些情况下的病因、诊断测试和治疗方法。大多数青春期延迟的儿童是男性，他们只是生长和青春期的体质性延迟。在青少年时期，尽管为此开发了各种内分泌测试，但仍难以将这种常见的良性情况与真正的促性腺激素缺乏区分开来。骨龄大于11.5岁的体质性青春期延迟个体，在曲普瑞林刺激后，促黄体生成素（LH）升高，这能够将他们与促性腺激素缺乏患者区分开来。我们认为，这可能是一项重要的筛查测试，用于排除青春期延迟男孩的促性腺激素缺乏。
