Metabolic Effects of Oral Versus Transdermal 17β-Estradiol (E2): A Randomized Clinical Trial in Girls With Turner Syndrome

Autor: Nancy Unanue, Judith L. Ross, Karen O Klein, Nelly Mauras, Jobayer Hossain, L. Torres-Santiago, Martha Taboada, Verónica Mericq, Ravinder J. Singh, Richard J. Santen
Rok vydání: 2013
Předmět:
Zdroj: The Journal of Clinical Endocrinology & Metabolism. 98:2716-2724
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2012-4243
Popis: Context: The long-term effects of pure 17β-estradiol (E2) depending on route of administration have not been well characterized. Objective: Our objective was to assess metabolic effects of oral vs transdermal (TD) 17β-E2 replacement using estrogen concentration-based dosing in girls with Turner syndrome (TS). Patients: Forty girls with TS, mean age 16.7 ± 1.7 years, were recruited. Design: Subjects were randomized to 17β-E2 orally or TD. Doses were titrated using mean E2 concentrations of normally menstruating girls as therapeutic target. E2, estrone (E1), and E1 sulfate (E1S) were measured by liquid chromatography tandem mass spectrometry and a recombinant cell bioassay; metabolites were measured, and dual-energy x-ray absorptiometry scan and indirect calorimetry were performed. Main Outcome: Changes in body composition and lipid oxidation were evaluated. Results: E2 concentrations were titrated to normal range in both groups; mean oral dose was 2 mg, and TD dose was 0.1 mg. After 6 and 12 months, fat-fr...
Databáze: OpenAIRE