The effect of glucocorticoid replacement therapy on bone mineral density in children with congenital adrenal hyperplasia
-
Semra Cetinkaya
und
Cengiz Kara
Abstract
Objectives: 1) To evaluate the effects of glucocorticoid (GC) doses on bone mineral density (BMD) in children with congenital adrenal hyperplasia (CAH), 2) Investigate other factors influencing BMD.
Methods: Twenty-six children with CAH and 11 healthy controls included in the study. All of the patients were examined with dual-energy X-ray absorptiometry (DXA) using a Hologic QDR 1000/W densitometer. The metabolic control state, age at diagnosis GC dose (mg/m2/day), pubertal status, 17 hydroxyprogesterone (17 OHP) levels, bone age (BA), and lumber BMD were evaluated in all cases. BMD (g/cm2), BMD z-score corrected to National Standards (cNS-BMD z-score), BMD z-score corrected to BA (cBABMD), bone mineral content (BMC), BMC corrected to puberty (cPBMC), and bone area (BAR) values were determined. Patients were grouped according to mean on-therapy serum 17 OHP levels as tight control (17 OHP<10 nmol/L) (n:13) and poor control (17 OHP>10 nmol/L) (n:13). All groups were compared with each other.
Results: The age range was 2.1–15.7 years and the mean age (±SD) 9.3 (±3.5) years. There were no significant differences between the groups in terms of GC doses, lumbar BMD values [BMD (g/cm2), BMD z-score corrected to National Standards (cNS-BMD z-score), BMD z-score corrected to BA (cBABMD), bone mineral content (BMC), BMC corrected to puberty (cPBMC), and bone area (BAR)]. However, the BMI value was higher in children with CAH than normal healthy controls. The BA of the poor control, late diagnosed groups and male patients were higher than tight control, early diagnosed group and female patients, respectively. BMC and BA were lower than the control group in tight control with early diagnosed patients. The cBABMD z-score was lower in males with poor control than males with tight control. There were no similar results in female patients.
Conclusions: Although GC treatment seems not to influence BMD in CAH patients in our study, further studies are needed to additionally evaluate daily calcium (Ca) intake, polymorphism of vitamin D receptor, ethnic factors (strict Islamic dress, etc.), socioeconomic status, and 24-h urinary free cortisol level.
©2011 by Walter de Gruyter Berlin Boston
Artikel in diesem Heft
- Publisher's Note
- Publisher's Note
- Editorial
- The damage caused by incomplete and uncontrolled medical information
- Images in Pediatric Endocrinology
- Dorsolumbar kyphosis: diagnostic value of hook shaped vertebra
- Original Contributions
- Are adolescent weight-related problems and general well-being essentially an issue of age, gender or rather a pubertal timing issue?
- Comparison of methimazole and propylthiouracil in the management of children and adolescents with Graves’ disease: efficacy and adverse reactions during initial treatment and long-term outcome
- The effect of glucocorticoid replacement therapy on bone mineral density in children with congenital adrenal hyperplasia
- Treatment of symptomatic osteoporosis in children: a comparison of two pamidronate dosage regimens
- Stanozolol regulates proliferation of growth plate chondrocytes via activation of ERα in GnRHa-treated adolescent rats
- A case of McCune-Albright syndrome associated with pituitary GH adenoma: therapeutic process and autopsy
- The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children
- A new heterozygous mutation (D196N) in the Gs alpha gene as a cause for pseudohypoparathyroidism type IA in a boy who had gallstones
- Causes and patterns of referral to a tertiary, multidisciplinary program for the treatment of childhood obesity
- Vitamin D receptor genotypes are associated with bone mass in patients with Turner syndrome
- Plasma leptin and adiponectin concentrations in healthy, non-obese children
- Puberty and pubertal growth dynamics in children with idiopathic short stature
- Endocrine complications following pediatric bone marrow transplantation
- Rare hypertension as a result of 17α-hydroxylase deficiency
- Girls with early puberty attain a near-final height similar to their target height
- Persistent hyperthyrotropinemia in congenital hypothyroidism: successful combination treatment with levothyroxine and liothyronine
- Benign transient hyperphosphatasemia in infants and children: a prospective cohort
- The relation between 25-hydroxyvitamin D with peak bone mineral density and body composition in healthy young adults
- Childhood obesity: evidence of an association between plasminogen activator inhibitor-1 levels and visceral adiposity
- Glargine basal-bolus insulin regimen versus insulin pump therapy: comparison of glycemic control
- Patient Report Letters
- A new variant of a known mutation in two siblings with permanent neonatal diabetes mellitus
- HNF1A mutation presenting with fetal macrosomia and hypoglycemia in childhood prior to onset of overt diabetes
- A newborn case with perinatal-lethal Gaucher disease due to R463H homozygosity complicated by C677T homozygosity in the MTHFR gene
- Hyperthyroidism presenting with hyperglycemia in an adolescent female
- Short Communications
- A single base-pair deletion in the WFS1 gene causes Wolfram syndrome
- Growth suppression caused by corticosteroid eye drops
- Familial glucocorticoid deficiency due to compound heterozygosity of two novel MC2R mutations
- Letter to the Editor
- Meetings
- Meetings Calendar
Artikel in diesem Heft
- Publisher's Note
- Publisher's Note
- Editorial
- The damage caused by incomplete and uncontrolled medical information
- Images in Pediatric Endocrinology
- Dorsolumbar kyphosis: diagnostic value of hook shaped vertebra
- Original Contributions
- Are adolescent weight-related problems and general well-being essentially an issue of age, gender or rather a pubertal timing issue?
- Comparison of methimazole and propylthiouracil in the management of children and adolescents with Graves’ disease: efficacy and adverse reactions during initial treatment and long-term outcome
- The effect of glucocorticoid replacement therapy on bone mineral density in children with congenital adrenal hyperplasia
- Treatment of symptomatic osteoporosis in children: a comparison of two pamidronate dosage regimens
- Stanozolol regulates proliferation of growth plate chondrocytes via activation of ERα in GnRHa-treated adolescent rats
- A case of McCune-Albright syndrome associated with pituitary GH adenoma: therapeutic process and autopsy
- The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children
- A new heterozygous mutation (D196N) in the Gs alpha gene as a cause for pseudohypoparathyroidism type IA in a boy who had gallstones
- Causes and patterns of referral to a tertiary, multidisciplinary program for the treatment of childhood obesity
- Vitamin D receptor genotypes are associated with bone mass in patients with Turner syndrome
- Plasma leptin and adiponectin concentrations in healthy, non-obese children
- Puberty and pubertal growth dynamics in children with idiopathic short stature
- Endocrine complications following pediatric bone marrow transplantation
- Rare hypertension as a result of 17α-hydroxylase deficiency
- Girls with early puberty attain a near-final height similar to their target height
- Persistent hyperthyrotropinemia in congenital hypothyroidism: successful combination treatment with levothyroxine and liothyronine
- Benign transient hyperphosphatasemia in infants and children: a prospective cohort
- The relation between 25-hydroxyvitamin D with peak bone mineral density and body composition in healthy young adults
- Childhood obesity: evidence of an association between plasminogen activator inhibitor-1 levels and visceral adiposity
- Glargine basal-bolus insulin regimen versus insulin pump therapy: comparison of glycemic control
- Patient Report Letters
- A new variant of a known mutation in two siblings with permanent neonatal diabetes mellitus
- HNF1A mutation presenting with fetal macrosomia and hypoglycemia in childhood prior to onset of overt diabetes
- A newborn case with perinatal-lethal Gaucher disease due to R463H homozygosity complicated by C677T homozygosity in the MTHFR gene
- Hyperthyroidism presenting with hyperglycemia in an adolescent female
- Short Communications
- A single base-pair deletion in the WFS1 gene causes Wolfram syndrome
- Growth suppression caused by corticosteroid eye drops
- Familial glucocorticoid deficiency due to compound heterozygosity of two novel MC2R mutations
- Letter to the Editor
- Meetings
- Meetings Calendar
