Bertelloni S, Baroncelli G I, Sorrentino M C, Costa S, Battini R, Saggese G
Endocrine Unit, Department of Paediatrics, University of Pisa, Via Roma 67, 56125 Pisa, Italy.
Calcif Tissue Int. 1997 Jul;61(1):1-5. doi: 10.1007/s002239900282.
The effect of peripheral androgen hypersensitivity on bone mineral density (BMD) was investigated in a group of adolescent women with idiopathic hirsutism (n = 17; mean age 17.0 +/- 1.7 years). The effect of long-term androgen-receptor blockade with flutamide (500 mg daily in two divided doses for 12 months) on BMD was assessed too. BMD was measured at lumbar spine (L2-L4) by a dual energy X-ray densitometer. Before flutamide treatment, patient BMD (1.14 +/- 0.07 g/cm2) was not significantly different from that of the control group (1.16 +/- 0.12 g/cm2, n = 22), and was normal for age and sex (BMD 0.14 +/- 0.69 SDS, P = NS vs. 0). After 12 months of treatment, absolute BMD in patients increased (1.18 +/- 0.08 g/cm2, P < 0.002), but SDS BMD did not change (0.21 +/- 0.72, P = NS vs. baseline). Flutamide treatment determined a clinical, marked improvement of androgen hypersensitivity (Ferriman-Gallwey score: before 22.0 +/- 6.2; 6 months: 13.2 +/- 6.4, P < 0.003; 12 months; 7.6 +/- 4.1, P < 0. 001; acne score: before 3.8 +/- 0.8; 3 months 0.8 +/- 0.5, P < 0. 001; later disappeared). The serum levels of 3alpha-androstenediol-glucoronide decreased (before: 8.6 +/- 1.1 microg/liter; 12 months: 7.2 +/- 1.0 microg/liter, P < 0.02), whereas the other endocrinological parameters did not change. No relationship was found between BMD and clinical or biochemical parameters of hyperandrogenism. We concluded that in adolescent women, peripheral hyperandrogenism is not associated with abnormal BMD; long-term treatment with flutamide, which blocks the androgen receptor, does not alter their BMD.
在一组患有特发性多毛症的青春期女性（n = 17；平均年龄17.0±1.7岁）中，研究了外周雄激素超敏反应对骨矿物质密度（BMD）的影响。还评估了用氟他胺（每日500 mg，分两次服用，共12个月）进行长期雄激素受体阻断对BMD的影响。采用双能X线骨密度仪测量腰椎（L2-L4）的BMD。在氟他胺治疗前，患者的BMD（1.14±0.07 g/cm2）与对照组（1.16±0.12 g/cm2，n = 22）无显著差异，且按年龄和性别分类属于正常范围（BMD 0.14±0.69 SDS，与0相比P =无统计学意义）。治疗12个月后，患者的绝对BMD增加（1.18±0.08 g/cm2，P < 0.002），但SDS BMD未改变（0.21±0.72，与基线相比P =无统计学意义）。氟他胺治疗使雄激素超敏反应在临床上得到显著改善（费里曼-高尔韦评分：治疗前22.0±6.2；6个月时13.2±6.4，P < 0.003；12个月时7.6±4.1，P < 0.001；痤疮评分：治疗前3.8±0.8；3个月时0.8±0.5，P < 0.001；之后消失）。血清3α-雄烯二醇葡糖苷酸水平降低（治疗前：8.6±1.1 μg/升；12个月时：7.2±1.0 μg/升，P < 0.02），而其他内分泌参数未改变。未发现BMD与高雄激素血症的临床或生化参数之间存在关联。我们得出结论，在青春期女性中，外周高雄激素血症与BMD异常无关；用氟他胺进行长期治疗，该药物可阻断雄激素受体，不会改变她们的BMD。
