The role of estrogen in bone growth and formation: Changes at puberty

Abstract

A high peak bone mass (PBM) at skeletal maturity is a good predictor for lower rate of fracture risks in later life. Growth during puberty contributes significantly to PBM achievement in women and men. The growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis has a critical role in pubertal bone growth. There is an increase in GH and IGF-1 levels during puberty; thus, it is assumed that sex steroids contribute to higher GH/IGF-1 action during growth. Recent studies indicate that estrogen increases GH secretion in boys and girls, and the major effect of testosterone on GH secretion is via aromatization to estrogen. Estrogen is pivotal for epiphyseal fusion in young men and women. From studies of individuals with a mutated aromatase gene and a case study of male patient with defective estrogen receptor-alpha (ER-α), it is clear that estrogen is indispensable for normal pubertal growth and growth plate fusion. ER-αand estrogen receptor-beta (ER-β) have been localized in growth plate and bone. ER knockout studies have shown that ER-α-/-female mice have reduced linear appendicular growth, while ER-β-/-mice have increased appendicular growth. No such effect is seen in ER-β-/-males; however, repressed growth is seen in ER-α-/-males, resulting in shorter long bones. Thus, ER-βrepresses longitudinal bone growth in female mice, while it has no function in the regulation of longitudinal bone growth in male mice. These findings indicate that estrogen plays a critical role in skeletal physiology of males as well as females © 2011 Singh et al, publisher and licensee Dove Medical Press Ltd.