title: Treatment of delayed male puberty: efficacy of aromatase inhibition.
abstract: We hypothesized that inhibition of estrogen synthesis would delay maturation of the growth plates and ultimately result in increased adult height in boys with delayed puberty. We conducted a randomized, double-blind, placebo-controlled study in which we treated boys with constitutional delay of puberty with testosterone plus placebo (testosterone-placebo) or with testosterone plus letrozole (testosterone-letrozole). Letrozole effectively inhibited estrogen synthesis: 17beta-estradiol concentrations increased in the testosterone-placebo group, but in the testosterone-letrozole group, no such increase was observed until letrozole treatment was discontinued. After 1.5 years, bone age had advanced by 1.7 +/- 0.3 years in the testosterone-placebo group, but by only 0.9 +/- 0.2 years in the testosterone-letrozole group (p = 0.02). Predicted adult height did not change significantly in the testosterone-placebo group, whereas in the testosterone-letrozole group the increase was 5.1 +/- 1.2 cm (p = 0.004). Our findings suggest that, if estrogen action is inhibited in growing adolescents, adult height will increase. This observation provides a rationale for studies aimed at delaying bone maturation in several growth disorders.
authors.affiliation: University of Helsinki, Hospital for Children and Adolescents, Finland. leo.dunkel@hus.fi
authors.forename: L
authors.initials: L
authors.lastname: Dunkel
authors.forename: S
authors.initials: S
authors.lastname: Wickman
mesh_terms: D000293:Adolescent; D047072:Aromatase Inhibitors; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D001846:Bone Development / Q000187:drug effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005544:Forecasting; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006128:Growth; D006728:Hormones / Q000097:blood; D006801:Humans; D000077289:Letrozole; D008297:Male; D009570:Nitriles / Q000627:therapeutic use*; D011628:Puberty, Delayed / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D013737:Testis / Q000187:drug effects / Q000254:growth & development; D013739:Testosterone / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D012739:Gonadal Steroid Hormones; D006728:Hormones; D009570:Nitriles; D014230:Triazoles; D013739:Testosterone; D000077289:Letrozole