Metabolic Effects of Oral Versus Transdermal 17β-Estradiol (E2): A Randomized Clinical Trial in Girls With Turner Syndrome

• DOI: 10.1210/jc.2012-4243
• Publication Date: 2013-05-15T20:20:58Z
• Authors: L. Torres-Santiago; V. Mericq; M. Taboada; N. Unanue; K. O. Klein; R. Singh; J. Hossain; R. J. Santen; J. L. Ross; N. Mauras
• Keywords: Diabetes and Metabolism; 03 medical and health sciences; Endocrinology; 0302 clinical medicine; Clinical Biochemistry; Biochemistry (medical); Biochemistry; 3. Good health

Context: The long-term effects of pure 17β-estradiol (E2) depending on route of administration have not been well characterized. Objective: Our objective was to assess metabolic effects of oral vs transdermal (TD) 17β-E2 replacement using estrogen concentration-based dosing in girls with Turner syndrome (TS). Patients: Forty girls with TS, mean age 16.7 ± 1.7 years, were recruited. Design: Subjects were randomized to 17β-E2 orally or TD. Doses were titrated using mean E2 concentrations of normally menstruating girls as therapeutic target. E2, estrone (E1), and E1 sulfate (E1S) were measured by liquid chromatography tandem mass spectrometry and a recombinant cell bioassay; metabolites were measured, and dual-energy x-ray absorptiometry scan and indirect calorimetry were performed. Main Outcome: Changes in body composition and lipid oxidation were evaluated. Results: E2 concentrations were titrated to normal range in both groups; mean oral dose was 2 mg, and TD dose was 0.1 mg. After 6 and 12 months, fat-fr...