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Bone mineral status in Egyptian children with classic congenital adrenal hyperplasia. A single-center study from Upper Egypt.
[congenital adrenal hyperplasia]
To
evaluate
bone
mineral
density
(
BMD
)
and
levels
of
bone
turnover
markers
in
Egyptian
children
with
classic
congenital
adrenal
hyperplasia
(
CAH
)
caused
by
21
-
hydroxylase
deficiency
and
its
relationship
with
disease-related
variables
.
The
study
population
consisted
of
28
children
from
Upper
Egypt
with
classic
CAH
,
their
mean
age
8
.
3
±
2
.
4
years
and
28
age
and
sex
matched
healthy
control
.
They
were
subjected
to
measurement
of
BMD
of
lumbar
spines
(
L
1
-
L
4
)
and
femoral
neck
using
dual-energy-
X-
ray
absorptiometry
(
DXA
)
and
laboratory
evaluation
of
bone
turnover
markers
including
Osteocalcin
and
serum
receptor
activator
of
nuclear
factor
κB-ligand
(
RANKL
)
.
Children
with
CAH
had
significantly
lower
bone
-mineral
density
(
BMD
)
for
both
,
vertebrae
and
femoral
neck
than
controls
.
This
difference
is
more
obvious
in
children
with
poor
control
and
in
those
receiving
prednisone
therapy
.
There
was
a
significantly
lower
serum
osteocalcin
,
and
significantly
higher
serum
RANKL
levels
in
patients
with
CAH
than
the
healthy
controls
.
This
differences
is
more
obvious
in
children
with
poor
control
and
in
those
receiving
prednisone
therapy
.
Total
bone
mineral
content
(
BMC
[
gm
]
)
have
significant
negative
correlations
to
age
(
r
=
-
0
.
81
,
P
<
0
.
001
)
,
disease
duration
(
r
=
-
0
.
881
,
P
<
0
.
001
)
,
17
OH
Progesterone
level
(
r
=
-
0
.
543
,
P
<
0
.
05
)
,
RANKL
level
(
r
=
-
0
.
635
,
P
<
0
.
05
)
,
and
significant
positive
correlation
with
osteocalcin
(
r
=
0
.
576
,
P
<
0
.
001
)
.
Children
from
Upper
Egypt
with
classic
CAH
may
have
reduced
BMD
and
increase
bone
turnover
compared
with
controls
.
This
difference
is
more
obvious
in
children
with
poor
control
and
in
those
receiving
prednisone
therapy
.
Active
monitoring
of
BMD
in
CAH
children
using
Dual-energy
X-
ray
absorptiometry
(
DEXA
)
scanning
.
Furthermore
,
effort
should
be
done
to
bring
hydrocortisone
to
Upper
Egypt
to
replace
prednisone
in
children
with
classic
congenital
adrenal
hyperplasia
.
Diseases
Validation
Diseases presenting
"bone turnover"
symptom
aromatase deficiency
congenital adrenal hyperplasia
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