Hiperplasia congenita das supra-renais por deficiencia classica da 21-hidroxilase : estudo transversal dos fatores envolvidos na densidade mineral ossea areal em 45 casos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2001

RESUMO

INTRODUCTION: Glucocorticoids are essential in the treatment of patients with Congenital Adrenal Hyperplasia (CAH). The opposite actions of glucocorticoids and androgens in bone mass achievement justifies a study of bone mineral density (BMD) inpatients with CAH due to c1assic21-hydroxylase deficiency (CYP21A2). OBJECTIVES: To evaluate BMD in patients with CAH and to investigate the involvement of possible clinieal and laboratory factors. PATIENTS AND METHODS: 45 patients with CAH, 28F:17M, 23 salt losers and 22 with the simple virilizing form, mean age of9.9 years (aged 5.1 to 16.3 years), followed in the Pediatric Endocrinology Unit at State University ofCampinas were studied. Abone densitometry using DEXA teehnique was performed. The values of the L2-L4 BMD z score were calculated in relation to chronologic age (CA) (BMD/CA), height age (RA) (BMDIHA) and bone age (BA) (BMD/BA) and then evaluated aecording compared to sex, CAH type, weight (in kg and z seore), height (in cm and z seore), body mass index (BMI in kglm2 and z score), pubertal development, CA in the diagnosis, CA and BA at the time of bone densitometry, duration of treatment, mean dose and type of glucocorticoids, and 17-hydroxyprogesterone levels 12 and 36 months before bone densitometry. Statistical analysis inc1uded Fisher, Wilcoxon and Kruskal- Wallis tests, with a = 0,05. RESUL TS: BMD/CA areal z score was significant1ylower in females and in patients with longer duration of treatment. Higher values were positively assoeiated with weight and BMI z seores, and with advaneed BA. The BMDIHA areal z score was also positively significant with weight and BMI z scores. BMD/BA areal z score was higher in patients with the smallest differencebetween BA and CA. The BMD/BA was significant1ylower than BMDIHA and BMD/CA, but there was not difference between. CONCLUSION: In patients with CAH CYP21A2 areal BMD/CA and BMDIHA may be overestimated; it in thus important to evaluate BMD in relation to BA. In these patients, weight, BMI and BA were the most important faetors involved in bone mass determination

ASSUNTO(S)

glicocorticoides densitometria androgenos osteoporose

ACESSO AO ARTIGO

Documentos Relacionados