الفهرس 
Normal PubertyOnly 14 pages are availabe for public view
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Abstract
Puberty constitutes a distinct developmental stage characterized by physiological, anatomical and psychological alterations and comprises a preparatory step for reproduction. CDGP is a variation of the onset and timing of pubertal development. Constitutional delay in growth and puberty is a common clinical observation in childhood and 3% of children have this condition. Individuals with CDGP have no underlying condition that causes pubertal delay and eventually undergo spontaneous pubertal development. Suboptimal nutrition, genetics, aberrations in insulin-like growth factor-1 (IGF-1) and growth hormone (GH) axis could be responsible factors in the etiology of constitutional delay of growth and puberty. High ghrelin concentrations could be implicated in altering the tempo of puberty in adolescents with CDGP.
The aim of this study is to evaluate ghrelin hormone levels among adolescent boys with constitutional delayed puberty and their relation with reproductive hormones including LH, FSH and Testosterone.
This study was conducted on 51 adolescent boys; 25 adolescent with constitutional delayed puberty and 26 healthy adolescents as controls matched for age.
Both groups were subjected to full history taking, thorough clinical examination including weight, height, BMI, blood pressure, testicular size, Tanner staging, assessment of bone age, laboratory investigations including serum FSH, LH, testosterone and ghrelin were also assessed.
The study revealed that a relationship exists between ghrelin hormone and CDGP. Ghrelin level appeared to be higher in adolescents with CDGP than normal and healthy individuals who had normal pubertal progression. Therefore, high level of ghrelin is capable of delaying puberty.
In addition, the study explored the effect of ghrelin on LH and FSH levels and found that ghrelin significantly had an inhibitory effect on LH and FSH.
Subsequently, the level of serum total testosterone was much lower in adolescents with CDGP than normal and healthy individuals. This could explain the role of ghrelin in causing sexual immaturity in CDGP.
Furthermore, weight, height and BMI were all lower in adolescents with CDGP than normal and healthy adolescents. This could imply that nutritional status of adolsecents may be responsible for the high levels of ghrelin, which in turn, delay puberty. This requires further investigations.
In this study, growth hormone basal and after stimulation appeared to be lower in adolescents with CDGP than in healthy normal individuals. There was a statistical significant difference between both groups as regard growth hormone.
Serum prolactin was not affected by ghrelin in both groups.
Finally, TSH and free T4 were also significantly lower in adolescents with CDGP than normal and healthy individuals. While moderate exercising showed no role in delaying puberty.
In conclusion, serum ghrelin plays an important role in constitutional delayed puberty.