Elevated bone turnover markers predict bone mineral density accrual in adolescents with 21‐hydroxylase deficiency
Authors' conclusion
Higher GC dose and the use of prednisolone were associated with decreased LSBMD accrual in adolescents with 21OHD. CTX z-score independently associated with LSBMD accrual, suggesting its potential for prognostic bone biomarker.
Study context
- Population
- Adolescents with classic 21-hydroxylase deficiency (21OHD) with baseline lumbar spine bone mineral density (LSBMD), bone age and BTM data; 55% female, 79% Tanner 5, mean age 14.6 ± 3.6 years
- Participants
- 33 adolescents
- Outcome
- Association of baseline BTM z-scores (OC, CTX) with annual percentage change in lumbar spine BMD (%∆LSBMD)
- Follow-up
- Mean 14.4 ± 5.6 months
Methodological detailsBTM concentrations converted into z-scores according to bone age
- BTM concentrations converted into z-scores according to bone age
Main finding
As reported in the abstract
- Median (Q1-Q3) %∆LSBMD
- 3.6% (0-8.5)/year
- %∆LSBMD increased across tertiles of CTX z-score
- p = .014
- %∆LSBMD correlated positively with CTX and osteocalcin (OC) z-scores
- p < .01
- In regression, only CTX z-score positively associated with %∆LSBMD, adjusted for sex, bone age (BA), BMI, testosterone, 25(OH)D, glucocorticoid (GC) type and dose
- p = .003
Observational data: associations, not effects.
Further findings
%∆LSBMD by sex and 21OHD subtype
- %∆LSBMD similar among genders or 21OHD subtypes
%∆LSBMD by GC type and dose
- Prednisolone vs hydrocortisone resulted in lower %∆LSBMD
- P = 0.004
- %∆LSBMD correlated negatively with GC dose
- P = 0.01
Original publication
Elevated bone turnover markers predict bone mineral density accrual in adolescents with 21‐hydroxylase deficiency. Clin Endocrinol (Oxf). Published 25 August 2022. doi:10.
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