TY - JOUR
T1 - ORAL VERSUS TRANSDERMAL ESTROGEN IN TURNER SYNDROME
T2 - A SYSTEMATIC REVIEW AND META-ANALYSIS
AU - Zaiem, Feras
AU - Alahdab, Fares
AU - Al Nofal, Alaa
AU - Murad, Mohammad Hassan
AU - Javed, Asma
N1 - Copyright:
Copyright 2017 Medline is the source for the citation and abstract of this record.
PY - 2017/4/2
Y1 - 2017/4/2
N2 - OBJECTIVE: To conduct a systematic review and meta-analysis comparing transdermal estrogens (TDEs) versus oral estrogens (OEs) in Turner syndrome (TS).RESULTS: Of 845 candidate references, 4 studies were included. Both OEs and TDEs were associated with an increase in whole-body bone mineral density (BMD) z-score, with TDE therapy displaying a greater increase. OEs were associated with higher fasting glucose and total cholesterol. Both OEs and TDEs reduced low-density lipo-protein cholesterol (LDL-C) and increased high-density lipoprotein cholesterol (HDL-C), with OEs providing a more favorable effect. The use of 17-β estradiol was associated with a higher total cholesterol and lower LDL-C than TDE. No statistically significant difference was found between OEs and TDEs in body mass index, fat mass, fat free mass, insulin-like growth factor 1, insulin-like growth factor binding protein 3, fasting insulin, triglycerides, estradiol, or estrone levels.METHODS: Randomized trials and observational comparative studies with a minimal follow-up of 6 months for skeletal and metabolic outcomes and serum hormone changes were included. Outcomes were pooled with a random effects model and are reported as mean differences between OE and TDE groups and 95% confidence intervals (CIs).CONCLUSION: In girls with TS, TDEs may be associated with a more beneficial effect on fasting glucose, cholesterol, and whole-body BMD. However, OEs have a more favorable impact on LDL-C and HDL-C. 17-β estradiol has a more favorable effect on LDL-C.ABBREVIATIONS: BMI = body mass index BMD = bone mineral density CI = confidence interval HDL-C = high density lipo-protein-cholesterol IGF-1 = insulin-like growth factor 1 IGF-BP3 = insulin-like growth factor binding protein 3 LDL-C = low density lipoprotein-cholesterol MD = mean difference OE = oral estrogen RCT = randomized controlled trial TDE = transdermal estrogen TS = Turner syndrome.
AB - OBJECTIVE: To conduct a systematic review and meta-analysis comparing transdermal estrogens (TDEs) versus oral estrogens (OEs) in Turner syndrome (TS).RESULTS: Of 845 candidate references, 4 studies were included. Both OEs and TDEs were associated with an increase in whole-body bone mineral density (BMD) z-score, with TDE therapy displaying a greater increase. OEs were associated with higher fasting glucose and total cholesterol. Both OEs and TDEs reduced low-density lipo-protein cholesterol (LDL-C) and increased high-density lipoprotein cholesterol (HDL-C), with OEs providing a more favorable effect. The use of 17-β estradiol was associated with a higher total cholesterol and lower LDL-C than TDE. No statistically significant difference was found between OEs and TDEs in body mass index, fat mass, fat free mass, insulin-like growth factor 1, insulin-like growth factor binding protein 3, fasting insulin, triglycerides, estradiol, or estrone levels.METHODS: Randomized trials and observational comparative studies with a minimal follow-up of 6 months for skeletal and metabolic outcomes and serum hormone changes were included. Outcomes were pooled with a random effects model and are reported as mean differences between OE and TDE groups and 95% confidence intervals (CIs).CONCLUSION: In girls with TS, TDEs may be associated with a more beneficial effect on fasting glucose, cholesterol, and whole-body BMD. However, OEs have a more favorable impact on LDL-C and HDL-C. 17-β estradiol has a more favorable effect on LDL-C.ABBREVIATIONS: BMI = body mass index BMD = bone mineral density CI = confidence interval HDL-C = high density lipo-protein-cholesterol IGF-1 = insulin-like growth factor 1 IGF-BP3 = insulin-like growth factor binding protein 3 LDL-C = low density lipoprotein-cholesterol MD = mean difference OE = oral estrogen RCT = randomized controlled trial TDE = transdermal estrogen TS = Turner syndrome.
UR - http://www.scopus.com/inward/record.url?scp=85021859892&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021859892&partnerID=8YFLogxK
U2 - 10.4158/EP161622.OR
DO - 10.4158/EP161622.OR
M3 - Article
C2 - 28095041
AN - SCOPUS:85021859892
SN - 1530-891X
VL - 23
SP - 408
EP - 421
JO - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
JF - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
IS - 4
ER -