Serum testosterone and oestradiol predict the growth response during puberty promoting treatment.
aromatase inhibitors
constitutional delay of puberty
growth
letrozole
oestradiol
puberty
testosterone
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
31
08
2021
received:
17
06
2021
accepted:
07
09
2021
pubmed:
2
10
2021
medline:
28
1
2022
entrez:
1
10
2021
Statut:
ppublish
Résumé
The influence of androgens and oestrogens on growth is complex, and understanding their relative roles is important for optimising the treatment of children with various disorders of growth and puberty. We examined the proportional roles of androgens and oestrogens in the regulation of pubertal growth in boys with constitutional delay of growth and puberty (CDGP). The study compared 6-month low-dose intramuscular testosterone treatment (1 mg/kg/month; n = 14) with per oral letrozole treatment (2.5 mg/day; n = 14) which inhibits conversion of androgens to oestrogen. Boys with CDGP were recruited to a randomized, controlled, open-label trial between 2013 and 2017 (NCT01797718). The patients were evaluated at 0-, 3- and 6-month visits, and morning blood samples were drawn. Linear regression models were used for data analyses. In the testosterone group (T-group), serum testosterone concentration correlated with serum oestradiol concentration at the beginning of the study and at 3 months, whereas in the letrozole group (Lz-group) these sex steroids correlated only at baseline. Association between serum testosterone level and growth velocity differed between the T and Lz groups, as each nmol/L increase in serum testosterone increased growth velocity 2.7 times more in the former group. Serum testosterone was the best predictor of growth velocity in both treatment groups. In the Lz-group, adding serum oestradiol to the model significantly improved the growth estimate. Only the boys with serum oestradiol above 10 pmol/L had a growth velocity above 8 cm/year. During puberty promoting treatment with testosterone or aromatase inhibitor letrozole, growth response is tightly correlated with serum testosterone level. A threshold level of oestrogen appears to be needed for an optimal growth rate that corresponds to normal male peak height velocity of puberty. Serum testosterone 1 week after the injection and serum testosterone and oestradiol 3 months after the onset of aromatase inhibitor treatment can be used as biomarkers for treatment response in terms of growth.
Substances chimiques
Testosterone
3XMK78S47O
Estradiol
4TI98Z838E
Letrozole
7LKK855W8I
Banques de données
ClinicalTrials.gov
['NCT01797718']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
220-226Subventions
Organisme : The Academy of Finland
Organisme : The Finnish Foundation for Pediatric Research
Organisme : Sigrid Jusélius Foundation
Organisme : Helsinki University Hospital Research Funds
Informations de copyright
© 2021 John Wiley & Sons Ltd.
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