Effects of androgen therapy on final adult height in boys with constitutional delay of growth and puberty: a meta-analysis of retrospective cohort studies

To systematically evaluate the effect of short-term androgen therapy on final adult height in boys with constitutional delay of growth and puberty (CDGP). Original studies investigating androgen therapy in children with CDGP and reporting final adult height as an outcome were retrieved from PubMed, Embase, Web of Science, and SpringerLink. The search period extended from database inception to September 2025. EndNote 20.0 was used for duplicate removal, and study quality was assessed using the Newcastle–Ottawa Scale (NOS). Literature screening, data extraction, and quality assessment were independently conducted by two researchers, with discrepancies resolved through consultation with a third researcher. Meta-analysis was performed using R 4.5.2 and Review Manager 5.4.1. A total of 13 eligible retrospective cohort studies involving 803 patients were included. Sensitivity analyses demonstrated good robustness of the pooled results, and Egger’s tests indicated no significant publication bias (P1 = 0.0794, P2 = 0.3982). Meta-analysis showed that, compared with untreated controls, androgen therapy—including testosterone and oxandrolone—significantly increased measured final adult height MD = 1.78 cm, 95% CI (0.47, 3.08), P = 0.0076 and significantly improved final height Z-scores MD = 0.24, 95% CI (0.07, 0.41), P = 0.0057. Subgroup analyses revealed that the low-dose regimen yielded the most favorable effect MD = 1.88 cm, 95% CI (0.63, 3.12), P = 0.003, whereas the medium-dose MD = 1.17 cm, 95% CI (-0.90, 3.25), P = 0.268 and high-dose regimens MD = 1.68 cm, 95% CI (-5.07, 8.42), P = 0.626 showed no statistically significant benefit. Short-course therapy was associated with greater improvement in final adult height compared with long-course therapy MD = 2.70 cm, 95% CI (1.30, 4.09), P < 0.001. In addition, testosterone demonstrated superior efficacy compared with oxandrolone MD = 2.64 cm, 95% CI (1.44, 3.80), P < 0.001. Short-term androgen therapy can improve final adult height in boys with CDGP, with low-dose, short-course testosterone regimens appearing to be the most favorable option. Given the limited number and retrospective nature of the included studies, these findings require further confirmation through high-quality comparative studies. Not applicable.