Vandewalle S, Taes Y, Fiers T, Toye K, Van Caenegem E, Roggen I, De Schepper J, Kaufman J-M
Departments of Endocrinology (S.V., Y.T., K.T., E.V.C., J.D.S., J.-M.K.), Pediatric Endocrinology (S.V., J.D.S.), and Hormonology (T.F.) and Unit for Osteoporosis and Metabolic Bone Diseases (S.V., Y.T., K.T., E.V.C., J.-M.K.), Ghent University Hospital, 9000 Ghent, Belgium; and Department of Pediatric Endocrinology (I.R., J.D.S.), Brussel University Hospital, 1090 Brussels, Belgium.
J Clin Endocrinol Metab. 2014 Jul;99(7):E1272-82. doi: 10.1210/jc.2013-3887. Epub 2014 Mar 26.
Although both testosterone (T) and estradiol (E2) are considered essential in the regulation of the male skeleton, there are few data concerning the relative contribution of T and E2 on bone mineral density (BMD), bone geometry, and bone maturation in healthy boys.
The objective of the study was to analyze the relationship between T and E2 and BMD, bone geometry, skeletal maturation, and body composition.
This is a cross-sectional study in 199 healthy boys (aged 6-19 y). T and E2 were determined by liquid chromatography tandem mass spectrometry. Whole-body and lumbar areal bone mineral density (aBMD) and bone area, lean mass, and fat mass were determined by dual-energy X-ray absorptiometry. Trabecular (distal site) and cortical (proximal site) volumetric BMD (vBMD) and bone geometry were assessed at the nondominant forearm and leg using peripheral quantitative computed tomography. Skeletal age was determined by an X-ray of the left hand.
T was positively associated with lean mass (P < .001), lumbar and whole-body bone area (P < .001), trabecular and cortical area (P < .01), and periosteal circumference (P < .01) at the radius. E2 was positively associated with lumbar and whole-body aBMD (P < .001), trabecular vBMD at the radius and tibia (P < .01), and cortical thickness at the radius (P < .05). E2 was an independent negative predictor of the endosteal circumference (P < .01). Moreover, E2 was positively associated with bone age advancement (P < .001).
Circulating E2 is positively associated with bone maturation and aBMD and vBMD and negatively with endosteal circumference in healthy boys, whereas T is a determinant of lean mass and bone size. These findings underscore the important role of E2 in skeletal development in boys.
尽管睾酮（T）和雌二醇（E2）在男性骨骼调节中均被认为至关重要，但关于T和E2对健康男孩骨矿物质密度（BMD）、骨几何形态和骨成熟度的相对贡献的数据较少。
本研究的目的是分析T和E2与BMD、骨几何形态、骨骼成熟度和身体成分之间的关系。
这是一项对199名健康男孩（6 - 19岁）的横断面研究。通过液相色谱串联质谱法测定T和E2。采用双能X线吸收法测定全身和腰椎的面积骨矿物质密度（aBMD）、骨面积、瘦体重和脂肪量。使用外周定量计算机断层扫描评估非优势前臂和腿部的小梁（远端部位）和皮质（近端部位）体积骨密度（vBMD）及骨几何形态。通过左手X线片确定骨骼年龄。
T与瘦体重（P <.001）、腰椎和全身骨面积（P <.001）、小梁和皮质面积（P <.01）以及桡骨骨膜周长（P <.01）呈正相关。E2与腰椎和全身aBMD（P <.001）、桡骨和胫骨的小梁vBMD（P <.01）以及桡骨皮质厚度（P <.05）呈正相关。E2是骨内膜周长的独立负向预测因子（P <.01）。此外，E2与骨龄进展呈正相关（P <.001）。
在健康男孩中，循环E2与骨成熟度、aBMD和vBMD呈正相关，与骨内膜周长呈负相关，而T是瘦体重和骨大小的决定因素。这些发现强调了E2在男孩骨骼发育中的重要作用。
