Nuti R, Martini G, Merlotti D, De Paola V, Valleggi F, Gennari L
Department of Internal Medicine, Endocrine-Metabolic Sciences, and Biochemistry, University of Siena, 53100 Siena, Italy.
J Endocrinol Invest. 2007;30(6 Suppl):18-23.
Sex steroid hormones play an important role in the maintenance of bone mass in males and in females. Even though androgens are the major sex steroids in men, direct and indirect evidence emerged suggesting that estrogens may also play a major role in male skeletal health. Since the testes account for only 15% of circulating estrogens in males, the remaining 85% comes from peripheral aromatization of androgen precursors in different tissues, including bone. Human models of aromatase deficiency clearly demonstrated the critical importance of the conversion of androgens into estrogens in regulating male skeletal homeostasis. Aromatase- deficient men showed tall stature due to continued longitudinal growth, unfused epiphyses, high bone turnover, and osteopenia. Interventional studies in adult men using aromatase inhibition confirmed that estrogens are important in controlling bone remodeling. Importantly either inherited (i.e. due to common polymorphisms at the human aromatase CYP19 gene) or acquired (i.e. by diseases or different compounds) variation in aromatase ability to convert androgen precursors into estrogen may also be relevant for skeletal homeostasis.
性类固醇激素在维持男性和女性骨量方面发挥着重要作用。尽管雄激素是男性主要的性类固醇，但直接和间接证据表明，雌激素在男性骨骼健康中可能也起着主要作用。由于睾丸仅占男性循环雌激素的15%，其余85%来自不同组织（包括骨骼）中雄激素前体的外周芳香化作用。芳香化酶缺乏的人体模型清楚地证明了雄激素转化为雌激素在调节男性骨骼内环境稳定中的关键重要性。芳香化酶缺乏的男性由于持续的纵向生长、骨骺未融合、高骨转换和骨质减少而身材高大。在成年男性中使用芳香化酶抑制剂的干预研究证实，雌激素在控制骨重塑方面很重要。重要的是，无论是遗传性的（即由于人类芳香化酶CYP19基因的常见多态性）还是获得性的（即由疾病或不同化合物引起）芳香化酶将雄激素前体转化为雌激素能力的变化，可能也与骨骼内环境稳定有关。
