Vertebral morphology in aromatase inhibitor-treated males with idiopathic short stature or constitutional delay of puberty.

Abstract

Aromatase inhibitors (AIs), blockers of estrogen biosynthesis, delay bone maturation and therefore are used increasingly to promote growth in children and adolescents with growth disorders. The effects of treatment on skeletal health are largely unknown. Since estrogen deficiency is associated with various detrimental skeletal effects, we evaluated in this cross-sectional posttreatment study vertebral body morphology, dimensions and endplates, and intervertebral disks by the use of magnetic resonance imaging (MRI) in two cohorts of males previously treated with the AI letrozole or placebo. Males with idiopathic short stature received treatment with letrozole or placebo for 2 years during prepuberty or early puberty; males with constitutional delay of puberty received letrozole or placebo in combination with low-dose testosterone for 1 year during early or midpuberty. In males with idiopathic short stature, mild vertebral body deformities were found in 5 of 11 (45%) letrozole-treated subjects, whereas in the placebo group no deformities were detected (p = .01). In the cohort of males with constitutional delay of puberty, a high prevalence of endplate and intervertebral disk abnormalities was observed in both the letrozole- and the placebo-treated groups. We conclude that AI therapy during prepuberty or early puberty may predispose to vertebral deformities, which probably reflect impaired vertebral body growth rather than impaired bone quality and compression fractures. If AIs are used in growth indications, follow-up of vertebral morphology is indicated.

• Authors: Matti Hero, Sanna Toiviainen-Salo, Sanna Wickman, Outi Mäkitie, Leo Dunkel
• Journal: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (J Bone Miner Res) Vol. 25 Issue 7 Pg. 1536-43 (Jul 2010) ISSN: 1523-4681 [Electronic] United States
• PMID: 20200972 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: 2010 American Society for Bone and Mineral Research.

Chemical References

• Aromatase Inhibitors
• Nitriles
• Triazoles
• Testosterone
• Letrozole

Topics

• Adolescent
• Aromatase Inhibitors (therapeutic use)
• Child
• Growth Disorders (drug therapy)
• Humans
• Letrozole
• Magnetic Resonance Imaging
• Male
• Nitriles (therapeutic use)
• Puberty
• Puberty, Delayed (drug therapy)
• Spine (anatomy & histology, drug effects, growth & development)
• Testosterone (therapeutic use)
• Triazoles (therapeutic use)