Endocrine Abstracts

It is established that the delayed puberty is the lack of development of sexual maturation in boys and girls at a chronological age that is 2.5 standard deviation above the mean age. Some possible causes of delayed puberty are: hypothalamic defects, pituitary defects or the gonads.

Objectives: Early diagnosis of the gonadal insufficiency; identification of the bone mass and the bone turnover at the pacients with delayed puberty; prophylaxis measures of the bone modification still in pre, puberal and postpuberal stage which lead to a maximal bone mass in correlation between sex and age.

Materials and methods: The study group includes 23 patients with age under 17–22 years with next forms of delayed puberty: Turner syndrome (8), gonadotropin deficiency (8), growth hormon deficiency with gonadal defects (5), nonsecreting pituitary tumors - the chromophobe adenoma (2). The diagnosis of osteoporosis was besed on BMD measurement using dual energy X-ray absorptiometry (DEXA). The cases were evaluated and diagnosed using the determination of levels seric of bone resorption represented by C-terminal telopeptide of tip I procollagen (CrossLaps) and as marker of bone formation represented by osteocalcine.

Results: Osteoporosis was found in 9 (T-score between −2.73 and −3.50), 7 presents osteopenia (T-score between −1.70 and −2.30) and 7 have normal BMD. The Crosslaps (1.054–2.1 ng/ml) and the calcitonina (47–149 ng/ml) were increased in osteoporosis and the results are comparative with postmenopausal women value, the pacients with osteopenia had identical results with premenopausal women value (osteocalcine 22.91–24.94 ng/ml, Crosslaps 0.179–0.250 ng/ml).

Conclusion: Early diagnosis of gonadic failure in order to stabilize/increase the bone mass and to reduce the fractures’ incidents, osteoporosis/osteopenia therapy associates estroprogestative/androgenic substitution with specific means of the bone remineralization (biphosphonates, calcium formulas and vitamin D derivates)

Keywords: delayed puberty, BMD, osteocalcine, Crosslaps.