BONE-MINERAL DENSITY AND BODY-COMPOSITION IN CONGENITAL ADRENAL-HYPERPLASIA
BONE-MINERAL DENSITY AND BODY-COMPOSITION IN CONGENITAL ADRENAL-HYPERPLASIA
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DOI：
10.1210/jc.80.7.2238
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发表时间：
1995-07-01
影响因子：
5.8
通讯作者：
WARK, JD
中科院分区：
文献类型：
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作者：
CAMERON, FJ;KAYMAKCI, B;WARK, JD
本研究的目的是评估先天性肾上腺增生 (CAH) 患者服用替代剂量的糖皮质激素是否会导致身体成分发生变化，包括全身或局部骨质疏松症。我们测量了 21 名 21-羟化酶缺乏症患者的身高、体重指数、瘦体重、脂肪量以及全身和局部骨矿物质密度 (BMD)。我们在 21 名年龄和性别匹配的对照患者中测量了相同的参数。与标准数据 (P = 0.0015) 和对照组 (P = 0.009) 相比，CAH 组（8-32 岁）的平均身高显着降低。 CAH组的平均体重指数与标准数据（P = 0.13）或对照组（P = 0.87）之间没有显着差异。CAH男性的脂肪/瘦体重比显着高于对照男性（P = 0.005）。 CAH组和对照组的全身平均骨矿物质表观密度值没有显着差异（P = 0.39）。然而，CAH 组和对照组的全身 BMD z 评分与参考数据之间存在显着差异（分别为 P = 0.027 和 P = 0.004）。就脊柱骨矿物质表观密度而言，总 CAH 组和对照组之间没有观察到显着差异；然而，CAH 男性的平均调整脊柱 BMD 显着低于男性对照组（P = 0.02）。我们得出的结论是，尽管在我们的 CAH 患者组中，糖皮质激素和盐皮质激素替代疗法在纵向生长方面可能不是最佳的，但就一般骨矿化而言，它并不有害。它可能会降低 CAH 男性的脊柱 BMD。我们还得出结论，BMD 的 Hologic 参考数据与澳大利亚人群的相关性尚不确定，因此需要澳大利亚标准数据。
The purpose of this study was to assess whether replacement doses of glucocorticoid hormones administered to patients with congenital adrenal hyperplasia (CAH) cause changes in body composition, including either generalized or regional osteoporosis.In 21 patients with 21-hydroxylase deficiency we measured height, body mass index, lean mass, fat mass, and whole body and regional bone mineral density (BMD). We measured the same parameters in 21 age- and sex-matched control patients.The CAH group (aged 8-32 yr) showed significantly reduced mean height compared with both standard data (P = 0.0015) and the control group (P = 0.009). There were no sigificant differences in mean body mass index between the CAH group and the standard data (P = 0.13) or the control group (P = 0.87).CAH males had significantly higher fat/lean mass ratios than control males (P = 0.005). There were no significant differences in whole body mean bone mineral apparent density values between the CAH and control groups (P = 0.39). There were, however, significant differences in whole body BMD z scores between the CAH and control groups and the reference data (P = 0.027 and P = 0.004, respectively). No significant differences were observed between the total CAH and control groups with respect to spinal bone mineral apparent density; however CAH males had significantly lower mean adjusted spinal BMD than the male controls (P = 0.02).We conclude that although replacement therapy with glucocorticoid and mineralocorticoid hormones in our group of CAH patients may not be optimal with regard to longitudinal growth, it is not deleterious in terms of general bone mineralization. It may decrease spinal BMD in CAH males. We also conclude that the relevance of Hologic reference data for BMD to an Australian population is uncertain, and there is a need For Australian standard data.