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Estrogens are essential for male pubertal periosteal bone expansion.
[aromatase deficiency]
The
skeletal
response
to
estrogen
therapy
was
studied
in
a
17
-
yr
-old
boy
with
congenital
aromatase
deficiency
.
As
expected
,
estrogen
therapy
(
1
mg
estradiol
valeriate
/
d
from
age
17
until
20
yr
)
normalized
total
and
free
testosterone
and
reduced
the
rate
of
bone
remodeling
.
Dual-energy
x-
ray
absorptiometry-assessed
areal
bone
mineral
density
(
BMD
)
of
the
lumbar
spine
and
femoral
neck
increased
significantly
(
by
23
%
and
14
%
,
respectively
)
,
but
peripheral
quantitative
computed
tomography
at
the
ultradistal
radius
revealed
no
gain
of
either
trabecular
or
cortical
volumetric
BMD
.
The
increase
in
areal
BMD
was
thus
driven
by
an
increase
in
bone
size
.
Indeed
,
longitudinal
bone
growth
(
height
,
+
8
.
5
%
)
and
especially
cross-sectional
area
of
the
radius
(
+
46
%
)
and
cortical
thickness
(
+
12
%
)
,
as
measured
by
peripheral
quantitative
computed
tomography
,
increased
markedly
during
estrogen
treatment
.
These
findings
demonstrate
that
androgens
alone
are
insufficient
,
whereas
estrogens
are
essential
for
the
process
of
pubertal
periosteal
bone
expansion
typically
associated
with
the
male
bone
phenotype
.
Diseases
Validation
Diseases presenting
"peripheral quantitative computed tomography"
symptom
aromatase deficiency
congenital adrenal hyperplasia
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