Hasegawa Yukihiro, Itonaga Tomoyo, Ikegawa Kento, Nishigaki Satsuki, Kawai Masanobu, Koga Eri, Sakakibara Hideya, Ross Judith L
Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
Clin Pediatr Endocrinol. 2020;29(2):49-53. doi: 10.1297/cpe.29.49. Epub 2020 Apr 16.
In females, endogenous estrogen secretion increases gradually before pubertal development. The benefits of low-dose estrogen therapy in patients with Turner syndrome were originally discussed by Ross and Quigley . These seminal studies used ethinyl estradiol (EE2), starting at a dose of 25 ng/kg/d. We hypothesized that the initial dosage of estrogen could be titrated to more closely mimic physiological increments of endogenous estrogen. Therefore, our recent study initiated EE2 treatment at a dosage of 1-2 ng/kg/d, an ultra-low-dose estrogen therapy in pediatric patients with Turner syndrome. The ultra-low-dose estrogen therapy in this syndrome produced a good final height outcome but achieved suboptimal bone mineral density (BMD). In the present review, we have explained our findings to clarify the merits and demerits of this new therapy and to promote further discussion and research. This type of ultra-low-dose estrogen therapy, initiated at an early age, could be ideal for estrogen replacement in female patients with hypogonadism, such as Turner syndrome.
在女性中，青春期发育前内源性雌激素分泌逐渐增加。Ross和Quigley最初讨论了低剂量雌激素疗法对特纳综合征患者的益处。这些开创性研究使用乙炔雌二醇（EE2），起始剂量为25 ng/kg/d。我们假设雌激素的初始剂量可以进行调整，以更接近地模拟内源性雌激素的生理增量。因此，我们最近的研究以1-2 ng/kg/d的剂量开始EE2治疗，这是一种针对特纳综合征儿科患者的超低剂量雌激素疗法。该综合征的超低剂量雌激素疗法产生了良好的最终身高结果，但骨矿物质密度（BMD）未达最佳。在本综述中，我们解释了我们的研究结果，以阐明这种新疗法的优缺点，并促进进一步的讨论和研究。这种早期开始的超低剂量雌激素疗法可能是性腺功能减退女性患者（如特纳综合征患者）雌激素替代的理想选择。
