These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Bone mineral density in relation to glucocorticoid substitution therapy in adult patients with 21-hydroxylase deficiency.
    Author: Jääskeläinen J, Voutilainen R.
    Journal: Clin Endocrinol (Oxf); 1996 Dec; 45(6):707-13. PubMed ID: 9039336.
    Abstract:
    OBJECTIVE: There are only limited data on bone mineral density (BMD) in adult patients with 21-hydroxylase deficiency (21-OHD). We have defined the effects of different glucocorticoid substitution therapies on BMD and body composition in these patients. DESIGN: Cross-sectional. PATIENTS: Thirty-two adult patients with 21-OHD. MEASUREMENTS: Patients were examined auxologically and biochemically. BMD was examined in the left femoral neck and lumbar vertebrae 2-4 (L2-4) with dual X-ray absorptiometry. The results were compared with national reference data. RESULTS: Mean height was 170.1 cm (-1.36 standard deviation scores (SDS) for the men and 156.3 cm (-1.68 SDS) for the women. These were significantly less (P < 0.001) than the mean national final heights. Mean BMD Z-score ((raw score - population reference mean)/SD) was -0.52 in L2-4 and -0.83 in the left femoral neck. Both these values were significantly less than the reference mean values (P = 0.045 and < 0.001, respectively). Both current and long-term mean glucocorticoid doses showed significant negative correlations with BMD in the left femoral neck as well as in L2-4. Patients substituted with hydrocortisone were less often over-treated and had better BMD Z-score means than patients substituted with prednisone, prednisolone or dexamethasone. CONCLUSIONS: In the follow-up of patients with 21-hydroxylase deficiency, care needs to be exercised to keep the glucocorticoid substitution dose to a minimum. In most cases decreased bone mineral density is a result of over-substitution.
    [Abstract] [Full Text] [Related] [New Search]