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Silvano Bertelloni, Giampiero I. Baroncelli, Giuseppe Saggese, Normal Volumetric Bone Mineral Density in Young Men with Histories of Constitutional Delay of Puberty—Authors’ Response, The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 9, 1 September 1999, Pages 3403–3406, https://doi.org/10.1210/jcem.84.9.6011-5
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We thank Dr. Finkelstein and coworkers for their letter, giving us the opportunity to discuss some aspects of bone mineral density (BMD) in young men with histories of constitutional delay of puberty (CDP).
As indicated in the letter (above), there is evident discrepancy between our data (1) and those of Finkelstein et al. (2, 3). We found reduced lumbar BMD area but normal BMD volume in young men with CDP (1), while they reported that both lumbar BMD area (2, 3) and BMD volume (letter) were decreased. In agreement with our data, Moore et al. (4) showed reduced lumbar BMD area and normal BMD volume in young men with histories of CDP; they also found normal femoral neck BMD volume (4).
In their letter, Finkelstein et al. suggest that androgen therapies administered to some of our patients during puberty may have influenced BMD measurement in young adulthood. We think this hypothesis is incorrect. In fact, no significant difference, in both BMD area and BMD volume at lumbar spine (1, 4) and femoral neck (4), has been found between men who received androgens during puberty and those left untreated. Finkelstein et al. also suggest that our results might be the consequence of the mean age of the control group. On this matter, we used the same criteria proposed by Finkelstein et al. (2) in selecting the controls. In addition, all the controls had attained final height before the BMD measurement and were more than 17 yr old. Thus, they were approaching their peak lumbar BMD (5, 6). Indeed, comparing lumbar BMD values of adolescents and adult men, it has been shown that lumbar peak bone mass is achieved by the age 17 yr in males (6). Finkelstein et al. (3) also wrote “the peak bone density of the spine and the femoral neck is usually reached between the ages of 16–18 yr in boys” (3). Thus, it is unlikely that the cause of the discrepancy between Finkelstein’s (2, 3) and our data lies in the age of controls (19 yr). However, we are following up both patients and controls to elucidate this aspect.
