Effect of adrenal androgen and estrogen on bone maturation and bone mineral density

To clarify the independent physiological roles of adrenal androgen and estr ogen on bone growth, we compared the lumbar spine bone mineral density (BMD ) in prepubertal girls with virilizing congenital adrenal hyperplasia (CAH) (n = 17) and girls with central precocious puberty (CPP) (n = 18). When BM D was analyzed according to chronologic age, no significant differences wer e found between CPP and CAH patients. However, when adjusted to bone age, B MD was statistically higher in CAH than in CPP subjects. This finding sugge sts that adrenal androgen, as well as estrogen, plays an important role in increasing BMD. Adrenal androgen may act on bone not only as androgen, but as estrogen after having been metabolized into an aromatized bone-active co mpound in peripheral tissues, such as bone and fat. Therefore, adrenal andr ogen may have a more important role in increasing BMD than previously reali zed. Copyright (C) 2001 by W.B. Saunders Company.