Bone Mineral Density and Body Composition in Children with Congenital Adrenal Hyperplasia

Abstract

Background: Children with congenital adrenal hyperplasia (CAH) are exposed to fluctuating cortisol and androgen levels. The effects these hormonal states have on bone mineral density (BMD) and body composition are not well studied. Objective: Compare BMD and body composition in children with CAH vs. healthy age-, sex-, and BMI-matched controls. Methods: Forty-two cases with CAH and 101 controls underwent a dual-energy X-ray absorptiometry scan. Bone age Z-scores were used as a surrogate for long-term androgen exposure in cases. Results: Children with CAH had lower BMD Z-scores than controls. In CAH cases, BMD Z-scores were positively correlated with bone age Z-scores. Body composition markers did not differ between children with CAH and controls. Conclusion: Lower BMD was observed in CAH cases, but no differences in body composition were identified. Among CAH cases, increased chronic androgen exposure, as measured by bone age Z-scores, was associated with higher BMD.