Bone mineral density in children and adolescents with congenital adrenal hyperplasia.

[congenital adrenal hyperplasia]

Chronic glucocorticoid therapy is associated with reduced bone mineral density . In paediatric patients with congenital adrenal hyperplasia , increased levels of androgens could not only counteract this effect , but could also advance bone age , with interference in the evaluation of densitometry . We evaluate bone mineral density in paediatric patients with classic congenital adrenal hyperplasia taking into account chronological and bone ages at the time of the measurement . Patients aged between 5 and 19 years underwent radiography of the hand and wrist followed by total body and lumbar spine densitometry . Chronological and bone ages were used in the scans interpretation . In fourteen patients , mean bone mineral density Z-score of total body to bone age was -0 .76 and of lumbar spine to bone age was -0 .26 , lower than those related to chronological age (+0 .03 and +0 .62 , resp .). Mean Z-score differences were statistically significant (P = 0 .004 for total body and P = 0 .003 for lumbar spine ). One patient was classified as having low bone mineral density only when assessed by bone age . We conclude that there was a reduction in the bone mineral density Z-score in classic congenital adrenal hyperplasia paediatric patients when bone age was taken into account instead of chronological age .