ormal bone health in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therap

Author(s)

Borges, Juliano Henrique ^[1] ; de Oliveira, Daniel Minutti ^[2] ; de Lemos-Marini, Sofia Helena Valente ^[1] ; Geloneze, Bruno ^[2] ; Guerra-Junior, Gil ^[1] ; Goncalves, Ezequiel Moreira ^[1]

Affiliation

^[1] State Univ Campinas UNICAMP, Lab Growth & Dev LabCreD, Ctr Invest Pediat CIPED, Sch Med Sci FCM, 126 Tessalia Vieira de Camargo St, BR-13083887 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, FCM, Lab Invest Metab & Diabet LIMED, Campinas, SP - Brazil

• Document type: Journal article
• Source: OSTEOPOROSIS INTERNATIONAL; v. 33, n. 1 AUG 2021.
• Web of Science Citations: 0

Abstract

It is of great importance to investigate any potential detrimental effect on bone health in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therapy. This study demonstrated normal bone health in well-controlled patients. Additionally, glucocorticoid dose may play an important role in the mineral density of femoral neck region. Purpose To compare regional bone mineral densities (BMDs) and bone statuses of young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency with a control group. The duration and dose of glucocorticoid therapy and relative skeletal muscle index (an indicator of sarcopenia) were also analyzed as parameters to predict bone health. Methods This case-control study included 23 patients (7 male and 16 female) and 20 controls (8 male and 12 female) matched by age range (18 to 31 years). Dual energy X-ray absorptiometry and phalangeal quantitative ultrasound (QUS) were used to estimate BMD and bone status, respectively. Results No difference was observed between patients and controls (of both sexes) in absolute values of BMD and Z-scores for the total body, lumbar spine, and femoral neck; or the bone status (estimated by phalangeal QUS). Multiple linear regression analysis demonstrated that relative skeletal muscle index independently correlated with BMD of the entire body (beta: 0.67, P = 0.007), the lumbar spine (beta: 0.73, P = 0.005), and the femoral neck (beta: 0.67, P = 0.007). However, the dose of glucocorticoids (beta: - 0.38, P = 0.028) independently correlated with BMD in the femoral neck region alone. Conclusion No signs of change in bone health were observed in patients with CAH when compared to the reference group. Additionally, a marker of sarcopenia was demonstrated to have a role in mineral density mechanisms in all analyzed bone sites. Only the femoral neck BMD seemed to be significantly dependent on glucocorticoid dose. (AU)

• FAPESP's process: 12/16778-8 - Cardiometabolic evaluation and pancreatic beta cell secretion pattern in congenital adrenal hyperplasia patients
• Grantee: Gil Guerra Júnior
• Support Opportunities: Regular Research Grants
• FAPESP's process: 11/23460-1 - Cardiometabolic risk in patients with classical Congenital Adrenal Hyperplasia due to 21-hydroxylase deficiency.
• Grantee: Ezequiel Moreira Gonçalves
• Support Opportunities: Scholarships in Brazil - Post-Doctoral