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Effect of low dose oxandrolone and testosterone treatment on the pituitary‐testicular and GH axes in boys with constitutional delay of growth and puberty
Author(s) -
Crowne E. C.,
Wallace W. H. B.,
Moore C.,
Mitchell R.,
Robertson W. H.,
Holly J. M. P.,
Shalet S. M.
Publication year - 1997
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.1997.t01-1-1150928.x
Subject(s) - oxandrolone , medicine , endocrinology , testosterone (patch) , placebo , morning , hormone , growth hormone , pathology , alternative medicine
OBJECTIVE To investigate the effect of low dose oxandrolone and testosterone on the pituitary‐ testicular and GH‐IGF‐I axes. DESIGN Prospective double‐blind placebo‐controlled trial. PATIENTS Sixteen boys with constitutional delay of growth and puberty (CDGP) with testicular volumes 4–6 ml were randomized to 3 months treatment: Group 1 ( n = 5), daily placebo: Group 2 ( n = 5), 2.5 mg oxandrolone daily or Group 3 ( n = 6), 50 mg testosterone monthly intramuscular injections with assessment (growth, pubertal development and overnight hormone profiles) at 0, 3, 6 and 12 months. MAIN OUTCOME MEASURES LH and GH profiles (15‐minute samples) were analysed by peak detection (Pulsar), Fourier transformation and autocorrelation. Testosterone levels were measured hourly and insulin, SHBG, IGF‐I, and IGFBP‐3 levels at 0800 h. Statistical analysis was by multivariate analysis of variance for repeated measures. RESULTS LH and testosterone parameters increased significantly with time in all 16 (LH AUC, P < 0.0001; peak amplitude, P = 0.02; number of peaks, P = 0.02; testosterone AUC, P = 0.02; morning testosterone, P = 0.002). In Group 2, however, LH and testosterone parameters decreased at 3 months followed by a rebound increase at 6 and 12 months. SHBG levels were markedly reduced at 3 months ( P = 0.006) and a wider range of dominant GH frequencies was present although GH AUC was not increased until 6 months, with an increase in GH pulse frequency but not amplitude. IGF‐I levels were increased at both 3 and 12 months. In Group 3, pituitary‐testicular suppression was not apparent, but GH levels increased with an increase in GH amplitude at 3 and 12 months. CONCLUSION Oxandrolone transiently suppressed the pituitary‐testicular axis and altered GH pulsatility. Testosterone increased GH via amplitude modulation.