Bone mineral density determinants in adolescents and young adults with congenital adrenal hyperplasia.

IF 2.1 3区 医学 Q2 PEDIATRICS
Frontiers in Pediatrics Pub Date : 2024-10-08 eCollection Date: 2024-01-01 DOI:10.3389/fped.2024.1456679
Ruta Navardauskaite, Aurika Vanckaviciene, Rasa Verkauskiene
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引用次数: 0

Abstract

Background: The effects of long-term glucocorticoid (GC) treatment on bone mineral density (BMD) in patients with congenital adrenal hyperplasia (CAH) remain controversial.

Objectives: This cross-sectional study aimed to evaluate BMD in relation to genotype, growth, vitamin D status, cumulative GC doses, and other relevant factors in youths with CAH.

Methods: Thirty-two patients with classical CAH (13 males; mean age 26.0 ± 7.1 years) were compared with 32 healthy controls matched by age and sex. BMD was measured using dual-energy x-ray absorptiometry, and statistical analyses, including the Mann-Whitney U-test and Spearman's correlation coefficient, were performed to evaluate differences and associations.

Results: Median whole-body and lumbar BMD Z-scores were similar between CAH patients and controls (p = 0.27 and 0.15, respectively). Low bone density was observed in 12.5% of CAH patients and 18.75% of controls (p = 0.5), and osteoporosis was confirmed in 12.5% of CAH patients and 0% of controls (p = 0.04). BMD did not correlate with cumulative GC doses, estradiol, renin, phosphate, sodium levels, or anthropometric parameters in CAH patients. There was no significant difference in BMD between severe and non-severe genotypes of CAH. However, a positive correlation was found between the whole-body BMD Z-score and growth velocity during infancy (r = 0.776, p = 0.021) in CAH patients. Vitamin D deficiency was noted in 56.25% of CAH patients, although vitamin D levels did not correlate with BMD or genotype. No history of bone fractures was reported among study participants.

Conclusions: CAH patients are at risk of developing osteoporosis, but in this study, BMD Z-scores were not associated with cumulative GC doses. The study did not identify an association between genotype and BMD. Poor growth during infancy was linked to decreased BMD in adulthood.

患有先天性肾上腺皮质增生症的青少年的骨质密度决定因素。
背景:长期糖皮质激素(GC)治疗对先天性肾上腺皮质增生症(CAH)患者骨矿物质密度(BMD)的影响仍存在争议:本横断面研究旨在评估先天性肾上腺皮质增生症(CAH)青少年患者的骨密度与基因型、生长、维生素 D 状态、累积 GC 剂量及其他相关因素的关系:将 32 名典型 CAH 患者(13 名男性;平均年龄为 26.0 ± 7.1 岁)与 32 名年龄和性别匹配的健康对照者进行比较。采用双能 X 射线吸收测量法测量 BMD,并进行曼-惠特尼 U 检验和斯皮尔曼相关系数等统计分析,以评估差异和关联:结果:CAH 患者和对照组的全身和腰椎骨密度 Z 值中位数相似(p = 0.27 和 0.15)。12.5%的CAH患者和18.75%的对照组观察到低骨密度(p = 0.5),12.5%的CAH患者和0%的对照组证实了骨质疏松症(p = 0.04)。CAH 患者的 BMD 与 GC 累积剂量、雌二醇、肾素、磷酸盐、钠水平或人体测量参数无关。重度和非重度 CAH 基因型之间的 BMD 没有明显差异。不过,CAH 患者全身 BMD Z 值与婴儿期生长速度之间存在正相关(r = 0.776,p = 0.021)。56.25%的CAH患者存在维生素D缺乏症,但维生素D水平与BMD或基因型无相关性。研究参与者中没有骨折史:结论:CAH 患者有患骨质疏松症的风险,但在本研究中,BMD Z 值与累积 GC 剂量无关。该研究并未发现基因型与 BMD 之间的关联。婴儿期发育不良与成年后骨密度降低有关。
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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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