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01-12-2022 | Congenital Adrenal Hyperplasia | Original Article

Association of androgen excess and bone mineral density in women with classical congenital adrenal hyperplasia with 21-hydroxylase deficiency

Authors: Dong Ho Lee, Sung Hye Kong, Han Na Jang, Chang Ho Ahn, Seung Gyun Lim, Young Ah Lee, Sang Wan Kim, Jung Hee Kim

Published in: Archives of Osteoporosis | Issue 1/2022

Abstract

Summary

The relationship between androgen excess and bone health in patients with congenital adrenal hyperplasia (CAH) with 21-hydroxylase (21-OH) deficiency is not fully understood. This study demonstrated positive correlations between androgen hormones and bone mineral density (BMD) in CAH women with 21-OH deficiency.

Purpose

This study aims to assess BMD and its association with androgen excess in women with CAH.

Methods

We enrolled 92 women with CAH with 21-OH deficiency and retrospectively reviewed their clinical features, hormone concentrations, body composition, glucocorticoid (GC) dose, and BMD.

Results

BMD was not different according to the subtypes of CAH. BMD at the lumbar spine was lower in women with CAH with regular menstruation than those with irregular menstruation (1.081 vs. 1.165 g/cm², P < 0.05). BMD was lower in women with CAH with 17-hydroxyprogesterone (17-OHP) < 10 ng/mL than in those with ≥ 10 ng/mL (lumbar spine, 1.019 vs. 1.150 g/cm²; femur neck, 0.806 vs. 0.899 g/cm²; total hip, 0.795 vs. 0.943 g/cm²; all P < 0.05). After adjusting for age and BMI in correlation analyses, testosterone concentrations were positively correlated with lumbar spine, femur neck, and total hip BMD (r = 0.46, r = 0.38, and r = 0.35, respectively; all P < 0.05), while 17-OHP was positively correlated with lumbar spine BMD (r = 0.38, P < 0.01). In subgroup analysis, 17-OHP was positively correlated with BMD (lumbar spine, r = 0.22; femur neck, r = 0.22; total hip, r = 0.24; all P < 0.05) only in the group with a total cumulative dose of GC ≥ 156.0 g/m².

Conclusion

Androgen excess may have a protective effect on BMD in women with classic CAH and high cumulative doses of GC.

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Title: Association of androgen excess and bone mineral density in women with classical congenital adrenal hyperplasia with 21-hydroxylase deficiency
Authors: Dong Ho Lee
Sung Hye Kong
Han Na Jang
Chang Ho Ahn
Seung Gyun Lim
Young Ah Lee
Sang Wan Kim
Jung Hee Kim
Publication date: 01-12-2022
Publisher: Springer London
Keywords: Congenital Adrenal Hyperplasia
Congenital Adrenal Hyperplasia
Glucocorticoid
Androgens
Testosterone
Published in: Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01090-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Association of androgen excess and bone mineral density in women with classical congenital adrenal hyperplasia with 21-hydroxylase deficiency

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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