title: Bone mineral density in children and adolescents with congenital adrenal hyperplasia.
abstract: 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.
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), 21941-901 Rio de Janeiro, RJ, Brazil ; Ambulatório de Endocrinologia, Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), UFRJ, Rua Bruno Lobo No. 50, 21941-912 Rio de Janeiro, RJ, Brazil.
authors.forename: Paulo Alonso
authors.initials: PA
authors.lastname: Garcia Alves Junior
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), 21941-901 Rio de Janeiro, RJ, Brazil ; Ambulatório de Endocrinologia, Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), UFRJ, Rua Bruno Lobo No. 50, 21941-912 Rio de Janeiro, RJ, Brazil.
authors.forename: Daniel Luis Gilban
authors.initials: DL
authors.lastname: Schueftan
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), 21941-901 Rio de Janeiro, RJ, Brazil.
authors.forename: Laura Maria Carvalho
authors.initials: LM
authors.lastname: de Mendonça
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), 21941-901 Rio de Janeiro, RJ, Brazil.
authors.forename: Maria Lucia Fleiuss
authors.initials: ML
authors.lastname: Farias
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), 21941-901 Rio de Janeiro, RJ, Brazil ; Ambulatório de Endocrinologia, Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), UFRJ, Rua Bruno Lobo No. 50, 21941-912 Rio de Janeiro, RJ, Brazil.
authors.forename: Izabel Calland Ricarte
authors.initials: IC
authors.lastname: Beserra
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