Estrogen, Bone, Growth and Sex: A Sea Change in Conventional Wisdom
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Melvin M. Grumbach
ABSTRACT
The discovery of a man with a homozygous mutation in the estrogen receptor α gene, which results in estrogen-receptor α resistance, and of males and females with autosomal recessive mutations in the CYP19 gene encoding aromatase, which leads to a failure to synthesize estrogens, has challenged conventional wisdom about the 'unimportant' role of estrogen in the male. For example, in the male, estrogen (not androgen), derived from direct testicular secretion (~20%) and from extragonadal aromatization of testosterone and androstenedione (~80%), is the critical sex hormone in the pubertal growth spurt, skeletal maturation, accrual of peak bone mass, and the maintenance of bone mass in the adult. Estrogen stimulates chondrogenesis in the epiphyseal growth plate increasing pubertal linear growth. At puberty, estrogen promotes skeletal maturation and the gradual, progressive closure of the epiphyseal growth plate, possibly as a consequence of both estrogen-induced vascular and osteoblastic invasion and the termination of chondrogenesis. In addition, during puberty and into the third decade, estrogen has an anabolic effect on the osteoblast and an apoptotic effect on the osteoclast, increasing bone mineral acquisition in axial and appendicular bone. In the adult, estrogen is important in maintaining the constancy of bone mass through its effects on remodeling and bone turnover. Establishing a role for estrogen does not exclude a direct action of testosterone on bone in the human male (especially on cortical bone), but this action is less characterized than thought in the past and is relatively minor in comparison with the major effect of estrogen in the male.
© 2014 by Walter de Gruyter Berlin/Boston
Artikel in diesem Heft
- Titelei
- TABLE OF CONTENTS
- Foreword
- What Happens When Growth Hormone is Discontinued at Completion of Growth? Metabolic Aspects
- Growth Hormone Deficiency and Peak Bone Mass
- Optimal Strategy for Management of Pituitary Disease in the Growth Hormone-Deficient Teenager
- Ethical Dilemmas in Pediatric Endocrinology: Growth Hormone for Short Normal Children
- Evidence-Based Approach to Growth Hormone Replacement Therapy in Adults, with Special Emphasis on Body Composition
- Evidence-Based Growth Hormone Therapy Prediction Models
- New Paradigms for Growth Hormone Treatment in the 21st Century: Prediction Models
- Role of Insulin-like Growth Factor Monitoring in Optimizing Growth Hormone Therapy
- Knockout Mice Challenge Our Concepts of Glucose Homeostasis and the Pathogenesis of Diabetes Mellitus
- Type 2 Diabetes Mellitus in Children: Pathophysiology and Risk Factors
- Emergence of Type 2 Diabetes Mellitus in Children: Epidemiological Evidence
- Treatment of Type 2 Diabetes Mellitus in Children and Adolescents
- Diagnosis of Maturity-Onset Diabetes of the Young in the Pediatric Diabetes Clinic
- Thrifty Genotypes and Phenotypes in the Pathogenesis of Type 2 Diabetes Mellitus
- Estradiol: A Protective Factor in the Adult Brain
- Estrogen Treatment and Estrogen Suppression: Metabolic Effects in Adolescence
- Estrogen, Bone, Growth and Sex: A Sea Change in Conventional Wisdom
- Route-Dependent Endocrine and Metabolic Effects of Estrogen Replacement Therapy
- Telomerase and the Cellular Lifespan: Implications for the Aging Process
- Human Aging and Progeria
- A Role for the Somatotropic Axis in Neural Development, Injury and Disease
- Hypothalamic Growth Hormone-Insulin-like Growth Factor-I Axis across the Human Life Span
- The Lost Voice: A History of the Castrato
- SELECTED POSTER ABSTRACTS
- GROWTH. FETAL GROWTH. SGA
- SYNDROMES: TURNER. PRADER-WILLI. NOONAN. PHP. OTHERS
- GHD. HYPOPITUITARISM. KIGS
- METABOLIC. GENETIC. ADULT. ACROMEGALY
- GH. IGF. IGFBPs
- GROWTH IN SYSTEMIC DISEASE. CRI. RICKETS. STEROIDS
Artikel in diesem Heft
- Titelei
- TABLE OF CONTENTS
- Foreword
- What Happens When Growth Hormone is Discontinued at Completion of Growth? Metabolic Aspects
- Growth Hormone Deficiency and Peak Bone Mass
- Optimal Strategy for Management of Pituitary Disease in the Growth Hormone-Deficient Teenager
- Ethical Dilemmas in Pediatric Endocrinology: Growth Hormone for Short Normal Children
- Evidence-Based Approach to Growth Hormone Replacement Therapy in Adults, with Special Emphasis on Body Composition
- Evidence-Based Growth Hormone Therapy Prediction Models
- New Paradigms for Growth Hormone Treatment in the 21st Century: Prediction Models
- Role of Insulin-like Growth Factor Monitoring in Optimizing Growth Hormone Therapy
- Knockout Mice Challenge Our Concepts of Glucose Homeostasis and the Pathogenesis of Diabetes Mellitus
- Type 2 Diabetes Mellitus in Children: Pathophysiology and Risk Factors
- Emergence of Type 2 Diabetes Mellitus in Children: Epidemiological Evidence
- Treatment of Type 2 Diabetes Mellitus in Children and Adolescents
- Diagnosis of Maturity-Onset Diabetes of the Young in the Pediatric Diabetes Clinic
- Thrifty Genotypes and Phenotypes in the Pathogenesis of Type 2 Diabetes Mellitus
- Estradiol: A Protective Factor in the Adult Brain
- Estrogen Treatment and Estrogen Suppression: Metabolic Effects in Adolescence
- Estrogen, Bone, Growth and Sex: A Sea Change in Conventional Wisdom
- Route-Dependent Endocrine and Metabolic Effects of Estrogen Replacement Therapy
- Telomerase and the Cellular Lifespan: Implications for the Aging Process
- Human Aging and Progeria
- A Role for the Somatotropic Axis in Neural Development, Injury and Disease
- Hypothalamic Growth Hormone-Insulin-like Growth Factor-I Axis across the Human Life Span
- The Lost Voice: A History of the Castrato
- SELECTED POSTER ABSTRACTS
- GROWTH. FETAL GROWTH. SGA
- SYNDROMES: TURNER. PRADER-WILLI. NOONAN. PHP. OTHERS
- GHD. HYPOPITUITARISM. KIGS
- METABOLIC. GENETIC. ADULT. ACROMEGALY
- GH. IGF. IGFBPs
- GROWTH IN SYSTEMIC DISEASE. CRI. RICKETS. STEROIDS
