Androgen-receptor blockade does not impair bone mineral density in adolescent females.
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.
Bertelloni
S
S
Endocrine Unit, Department of Paediatrics, University of Pisa, Via Roma 67, 56125 Pisa, Italy.
Baroncelli
G I
GI
Sorrentino
M C
MC
Costa
S
S
Battini
R
R
Saggese
G
G
D015502:Absorptiometry, Photon; D000152:Acne Vulgaris / Q000188:drug therapy / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D059002:Androgen Receptor Antagonists; D015113:Androstane-3,17-diol / Q000031:analogs & derivatives / Q000097:blood; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D005485:Flutamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006628:Hirsutism / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D000726:Androgen Antagonists; D059002:Androgen Receptor Antagonists; D012738:Sex Hormone-Binding Globulin; D015113:Androstane-3,17-diol; C028895:androstane-3,17-diol glucuronide; D003687:Dehydroepiandrosterone; D005485:Flutamide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone