Impact of aromatase inhibition on bone mineral density and structure: a randomized controlled trial in boys with delayed puberty
Abstract
OBJECTIVE: Treatment of boys with delayed puberty (DP) with aromatase inhibitor or low-dose testosterone (T) induces different hormonal milieus allowing assessment of the relative roles of sex steroids in bone metabolism.
DESIGN: A prospective randomized controlled trial (NCT01797718).
METHODS: Peripheral quantitative computed tomography (pQCT) of the non-dominant arm and left leg was performed in 27 boys with DP. Fifteen boys were treated with letrozole (Lz) (2.5 mg/day) and 12 boys with T (1 mg/kg every 4 weeks) for 6 months. pQCT scans were performed at 0, 6, and 12 months. Circulating bone status indices were measured at 0, 3, 6, and 12 months.
RESULTS: Between 0 and 3 months, levels of bone formation markers (P1NP, BAP) increased more in the T group than in the Lz group (P = .001-.014). Accordingly, T-treated boys exhibited greater gain in bone mineral content (BMC) between 0 and 6 months at distal site of tibia than the boys in the Lz group (mean 18.1 mg/mm [25.4] vs. -1.8 mg/mm [SD 1.0], respectively P = .043). No significant between-group differences were observed in cortical or endosteal parameters. In both groups, the changes in testosterone levels during the treatment correlated positively with changes in BMC at distal radius (both P = .041).
CONCLUSIONS: Testosterone treatment increased bone formation markers and predicted greater BMC accrual than Lz at metabolically active skeletal sites. These findings reinforce the anabolic role of androgens, partly mediated…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
Read the paper
Related studies
- Development of a crushable foam model for human trabecular bone
- Data-driven motion compensation in HR-pQCT.
- Modeling of structure, quality, and function in the orthodontic patient
- Exploring the mechanism of Heidihuang Pill in the treatment of osteoporosis based on network pharmacology, molecular docking, and experimental validation
- Effect of fabric on the accuracy of computed tomography-based finite element analyses of the vertebra
- Use of interventions involving virtual reality tasks during the climacteric: a systematic review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.