Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, Inciraltı-Balcova, İzmir, 35340, Turkey.
Division of Pediatric Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
Pediatr Cardiol. 2024 Feb;45(2):228-239. doi: 10.1007/s00246-023-03260-4. Epub 2023 Aug 6.
Aromatase inhibitors (AIs) are increasingly used in children and adolescents to augment adult height. The aim of this study was to investigate the effects AIs have on cardiac morphology, functions and their relation to several metabolic parameters in adolescent boys.
Three groups matched for sex (boys, n = 67), age (median age 13.5 years), weight, height, body mass index, and puberty stages were enrolled: (i) Group 1: 23 patients using AIs (only AI (n = 6) or in combination with growth hormone (GH) (n = 17)) for at least 6 months; (ii) Group 2: 22 patients using only GH, and (iii) Group 3: 22 healthy boys. Two-dimensional, M-mode conventional Doppler and tissue Doppler examinations of the left ventricle (LV) were performed. Bioelectrical bioimpedance analyses was conducted and follicle-stimulating hormone, luteinizing hormone, total testosterone, lipid, and hemogram parameters were obtained.
Patients in Group 1 had significantly higher serum total testosterone (p < 0.001) and hemoglobin (p < 0.001) levels, fat free mass (p = 0.005), LV mass (LVM) (p = 0.002), as well as increased LV posterior wall diameter (LVPWD) (p = 0.002), interventricular septum diameter (IVSD) (p = 0.019), and myocardial systolic wave velocity (Sm) (p = 0.020) compared to the two other control groups. No significant differences were observed in terms of diastolic and systolic functions and lipid profiles (p > 0.05). There were positive correlations between total testosterone, hemoglobin levels, LVM, LVPWD and IVSD (p < 0.05).
Increased LVM, LVPWD, IVSD and Sm of patients receiving AI therapy in comparison to the control groups, and the significant correlations of these parameters with total testosterone and hemoglobin levels were determined as potential side effects of AIs. These findings emphasize the need of routine cardiac follow-up in patients using AIs.
芳香化酶抑制剂（AIs）在儿童和青少年中越来越多地被用于增加成年身高。本研究的目的是探讨 AIs 对青少年男性心脏形态、功能的影响及其与多种代谢参数的关系。
我们招募了三组年龄（中位数为 13.5 岁）、体重、身高、体重指数和青春期阶段相匹配的男孩：（i）第 1 组：23 名接受 AI 治疗（仅 AI（n=6）或联合生长激素（GH）（n=17））至少 6 个月的患者；（ii）第 2 组：22 名仅接受 GH 治疗的患者；（iii）第 3 组：22 名健康男孩。对左心室（LV）进行二维、M 型常规多普勒和组织多普勒检查。进行生物电阻抗分析，并获得卵泡刺激素、黄体生成素、总睾酮、血脂和血液参数。
第 1 组患者的血清总睾酮（p<0.001）和血红蛋白（p<0.001）水平、去脂体重（p=0.005）、LV 质量（LVM）（p=0.002）以及 LV 后壁直径（LVPWD）（p=0.002）、室间隔直径（IVSD）（p=0.019）和心肌收缩波速度（Sm）（p=0.020）均显著升高与其他两组对照组相比。在舒张和收缩功能以及血脂谱方面无显著差异（p>0.05）。总睾酮、血红蛋白水平、LVM、LVPWD 和 IVSD 之间存在正相关（p<0.05）。
与对照组相比，接受 AI 治疗的患者的 LVM、LVPWD、IVSD 和 Sm 增加，这些参数与总睾酮和血红蛋白水平的显著相关性被确定为 AI 的潜在副作用。这些发现强调了在使用 AI 的患者中进行常规心脏随访的必要性。
