Height, Bone Mineral Density and Bone Markers in Congenital Adrenal Hyperplasia

Abstract

Aim: To evaluate height, bone growth, areal bone mineral density (aBMD), volumetric bone mineral density (vBMD) and markers of bone turnover in a group of patients affected by congenital adrenal hyperplasia (CAH). Patients: There were 50 patients (23 males, 27 females), aged 1–28 years, affected by CAH due to 21-hydroxylase deficiency: 27 with the salt-wasting (SW); 14 with the simple virilizing (SV), and 9 with the nonclassical (NC) forms. Methods: Bone morphometry was evaluated with the metacarpal index (MI) and lumbar aBMD and vBMD (L2–L4) by dual energy X-ray absorptiometry. Serum osteocalcin was used as a marker of bone formation, while urinary cross-linked N-telopeptides of type-I collagen and free deoxypyridinoline levels were evaluated as indexes of bone resorption. Results: The height standard deviation score (SDS) was –0.41 ± 1.4 in SW patients, –0.01 ± 1.9 in SV patients, and –0.01 ± 2.3 in NC patients. There was no significant difference among groups and against zero. The MI SDS was also not different between groups and against zero.aBMD was significantly lower in the pubertal patients compared with normal values, but only when patients with the SW and SV forms were considered together (p < 0.05). vBMD was significantly reduced in all patients with the classical form. Bone markers were not different in patients and controls. Conclusion: Our study shows that normal height can be attained in CAH patients; however, an impairment in bone growth and mineralization may be found in adolescents and young adults affected by the classical form.

Bone Mineral Status in Children with Congenital Adrenal Hyperplasia

“…The majority of studies have found normal bone density in both children and young adults with CAH [18][19][20][21][22] . However, some data indicate skeletal deficits 23 . Bone mineral density and bone mineral content in our participants were normal and did not correlate with current glucocorticoid dose or androgen levels.…”

Bone mineral density and vitamin D status in children and adolescents with congenital adrenal hyperplasia

“…It is known that osteoporosis risk is higher in adult patients with CAH compared to the normal population (6)(7)(8)(9). However, in younger CAH patients there are contradictory results in published studies and case reports that reported that BMD values were not changed or decreased (10)(11)(12)(13)(14)(15)(16)(17)(18). This situation may be related to smaller numbers of patients, extensive range of age distribution, and heterogeneous glucocorticoid dose among groups.…”

Genetic, anthropometric and metabolic features of adult Norwegian patients with 21-hydroxylase deficiency

“…Most studies have reported increased BMI in 21OHD patients (7,8), but not in all (9), and some studies have reported increased fat mass (7,8,9). Glucocorticoid therapy may also reduce bone mineral density (BMD), whereas androgens increase BMD in men (10), and studies have shown reduced (11), normal (12) and increased BMD (13) in 21OHD patients. Little is known about the risk of cardiovascular and other metabolic diseases.…”