Gonadotropin-Releasing Hormone Agonist Therapy and Longitudinal Bone Mineral Density in Congenital Adrenal Hyperplasia
Authors' conclusion
In children with CAH, GnRHa does not compromise BMD. However, BMD decreases with time and during the second and third decades of life is a possible effect of chronic supraphysiologic glucocorticoids. Children with CAH who experience early puberty benefit from GnRHa treatment as evidenced by the positive effect on height.
Study context
- Population
- Patients with classic CAH due to 21-hydroxylase deficiency, followed with DXA at puberty onset, adult height and early adulthood
- Participants
- 61 patients
- Exposure
- Gonadotropin-releasing hormone analog (GnRHa)-treated vs untreated
- GnRHa-treatedn = 20
- Outcome
- Whole body, lumbar spine, femoral neck, total hip and distal radius BMD z-score
- Follow-up
- Adult height
Main finding
As reported in the abstract
BMD z-score, all sites
- No differences in bone mineral density (BMD) between GnRHa-treated and untreated groups at adult height for all sites
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Height outcome vs predicted height at puberty onset, adjusted for midparental heightGnRHa correlated with improved height outcomes | P = 0.02 |
Longitudinal BMD z-scores, overall (follow-up DXA during early adulthood)
- Decrease in whole body BMD z-score
- P = 0.01
- Decrease in lumbar spine BMD z-score
- P < 0.0001
- Decrease in femoral neck BMD z-score
- P = 0.06
- Decrease in total hip BMD z-score
- P = 0.009
- Decrease in distal radius BMD z-score
- P = 0.05
Adult height
- Both groups achieved similar adult height
Original publication
Gonadotropin-Releasing Hormone Agonist Therapy and Longitudinal Bone Mineral Density in Congenital Adrenal Hyperplasia. J Clin Endocrinol Metab. Published 29 August 2023. doi:10.
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