Bone Health in Youth with Congenital Adrenal Hyperplasia: Abdominal and Total Adiposity Is Associated with Bone Mineral Density
Authors' conclusion
Adiposity negatively impacts BMD in CAH youth, independent of BMI and GC dose, potentially increasing the risk of osteoporosis in adulthood. Further research is needed to explore strategies to mitigate these effects.
Study context
- Population
- Youth with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency and age- and sex-matched controls
- Participants
- 35 vs 38
- Exposure
- Youth with CAH vs age- and sex-matched controls
- CAHn = 35
- Controlsn = 38reference
- Outcome
- Association of whole body and LS areal bone mineral density (BMD) height-adjusted Z-score (LS aBMDHAZ) with adiposity (SAT, VAT by MRI; % body fat by DXA), hormones and inflammatory markers, adjusted for GC dose and BMI-z
Methodological detailsage- and sex-matched controls
- Age- and sex-matched controls
Main finding
As reported in the abstract
Association of LS aBMDHAZ with adiposity, adjusted for BMI-z and GC dose
CAH: LS aBMDHAZ vs SAT, β
−1.21
95% CI −2.17, −0.24p = 0.014
CAH: LS aBMDHAZ vs VAT, β
−0.38
95% CI −0.77, 0.02p = 0.061
CAH: LS aBMDHAZ vs total % body fat, β
−0.63
95% CI −1.23, −0.03p = 0.039
Controls: LS aBMDHAZ vs VAT, β (95% CI −0.77, −0.01; p = 0.044); only VAT associated
−0.39
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Adiposity (SAT, VAT, total % body fat)Significantly higher in CAH | Ps <0.01 |
Areal BMDHAZ
- Within normal limits in both groups; in CAH, LS aBMDHAZ declined with age
BMDHAZ vs adrenal hormones and MCP-1
- No associations found
Original publication
Bone Health in Youth with Congenital Adrenal Hyperplasia: Abdominal and Total Adiposity Is Associated with Bone Mineral Density. Horm Res Paediatr. Published 30 September 2025. doi:10.
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