Height, bone mineral density and bone markers in congenital adrenal hyperplasia

Aim: To evaluate height, bone growth, areal bone mineral density (aBMD), vo lumetric bone mineral density (vBMD) and markers of bone turnover in a grou p of patients affected by congenital adrenal hyperplasia (CAH). Patients: T here were 50 patients (23 males, 27 females), aged 1-28 years, affected by CAH due to 21-hydroxylase deficiency: 27 with the salt-wasting (SW); 14 wit h the simple virilizing (SV), and 9 with the nonclassical (NC) forms. Metho ds: Bone morphometry was evaluated with the metacarpal index (MI) and lumba r aBMD and vBMD (L2-L4) by dual energy X-ray absorptiometry. Serum osteocal cin was used as a marker of bone formation, while urinary cross-linked N-te lopeptides of type-I collagen and free deoxypyridinoline levels were evalua ted as indexes of bone resorption. Results: The height standard deviation s core (SDS) was -0.41 +/- 1.4 in SW patients, -0.01 +/- 1.9 in SV patients, and -0.01 +/- 2.3 in NC patients. There was no significant difference among groups and against zero. The MI SDS was also not different between groups and against zero. aBMD was significantly lower in the pubertal patients com pared with normal values, but only when patients with the SW and SV forms w ere considered together (p < 0.05). vBMD was significantly reduced in all p atients with the classical form. Bone markers were not different in patient s and controls. Conclusion: Our study shows that normal height can be attai ned in CAH patients; however, an impairment in bone growth and mineralizati on may be found in adolescents and young adults affected by the classical f orm. Copyright (C) 2001 S.Karger AG, Basel.