Study Objective

To evaluate the effects of physiological dose 17 beta-estradiol (E₂) replacement on low bone mineral density (BMD) and compare the results of oral and transdermal (TD) E₂ administration in adolescents and young women with hypogonadism

Design, Setting, and Participants

We retrospectively reviewed the medical records of patients aged 15 to 24 years who were diagnosed with hypogonadism, who had begun receiving oral or TD E₂ replacement, and whose initial dual-energy X-ray absorptiometry scan detected a lumbar spine BMD Z-score of -1 or lower between 2014 and 2018. The patients were divided into 2 groups according to the E₂ route of administration as those who received 2 mg orally (Group 1) and 0.1 mg TD (Group 2).

Interventions

None

Main Outcome Measure

BMD scans of the patients at baseline and repeated within 2 years after E₂ replacement

Results

In total, 43 patients who met the inclusion criteria were included in the study. Two groups did not differ for BMD scores at baseline. A significant improvement in BMD was observed with physiological dose E₂ replacement in both groups. Mean BMD Z-score increased by +0.7 (95% CI, 0.47-0.93) in response to TD E₂ administration, compared with +0.41 (95% CI, 0.25-0.58) during oral E₂ replacement (P = .037).

Conclusion

We conclude that physiological dose E₂ replacement, even within a short period of 2 years, has a significant beneficial effect on bone mass acquisition on the lumbar spine. Our study also demonstrates the possible superiority of TD E2 replacement over the oral route in increasing lumbar spine BMD.

中文翻译：

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激素替代疗法对患有性腺功能减退症的青少年和年轻女性低骨密度的影响：口服和经皮 17 β-雌二醇给药的比较

学习目标

评估生理剂量 17 β-雌二醇 (E ₂ ) 替代疗法对低骨密度 (BMD) 的影响，并比较口服和经皮 (TD) E ₂给药对患有性腺功能减退症的青少年和年轻女性的结果

设计、设置和参与者

我们回顾性分析了 15 至 24 岁被诊断患有性腺功能减退症、已开始接受口服或 TD E ₂替代治疗且其初始双能 X 射线骨密度扫描检测到腰椎 BMD Z 评分为-1 或低于 2014 年至 2018 年。根据 E ₂给药途径将患者分为 2 组，即口服 2 mg（第 1 组）和 0.1 mg TD（第 2 组）。

干预措施

没有任何

主要指标

_{基线时和 E 2}置换后 2 年内重复的患者 BMD 扫描

结果

总共有 43 名符合纳入标准的患者被纳入研究。两组在基线时的 BMD 分数没有差异。在两组中都观察到生理剂量 E ₂替代的 BMD 有显着改善。平均 BMD Z 评分响应于 TD E ₂给药增加了 +0.7（95% CI，0.47-0.93），而口服 E ₂替代期间为 +0.41（95% CI，0.25-0.58） （P  = .037） .

结论

我们得出结论，生理剂量 E ₂替代，即使在短短 2 年内，对腰椎的骨量获取也有显着的有益影响。我们的研究还表明，在增加腰椎 BMD 方面，TD E2 替代疗法可能优于口服途径。