{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:02:24Z","timestamp":1788447744312,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with congenital adrenal hyperplasia (CAH) type and doses of glucocorticoids used as well as sex hormone secretion during puberty have important actions on bone mineral density (BMD) in adulthood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate BMD in adult CAH patients depending on current glucocorticoid therapy and on androgen levels in adulthood and at age 16\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 244 CAH patients from the dsd\u2010LIFE cohort (women n\u00a0=\u00a0147, men n\u00a0=\u00a097; salt\u2010wasting n\u00a0=\u00a0148, simple\u2010virilizing n\u00a0=\u00a071, nonclassical n\u00a0=\u00a025) in which BMD and bloods were available. Clinical and hormonal data at age 16years were retrieved from patients' files.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Simple\u2010virilizing women showed lower BMD compared to salt\u2010wasting women at trochanter (0.65\u00a0\u00b1\u00a00.12 vs 0.75\u00a0\u00b1\u00a00.15\u00a0g\/cm<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.050), whole femur T\u2010score (\u22120.87\u00a0\u00b1\u00a01.08 vs \u22120.16\u00a0\u00b1\u00a01.24; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05) and lumbar T\u2010score (\u22120.81\u00a0\u00b1\u00a01.34 vs 0.09\u00a0\u00b1\u00a01.3; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.050). Fracture prevalence did not differ significantly between the CAH groups. Prednisolone vs. hydrocortisone only therapy caused worse trochanter Z\u2010score (\u22121.38\u00a0\u00b1\u00a01.46 vs \u22120.47\u00a0\u00b1\u00a01.16; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.050). In women lumbar spine, BMD correlated negatively with hydrocortisone\u2010equivalent dose per body surface (r<jats:sup>2<\/jats:sup>\u00a0=\u00a00.695, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Furthermore, BMI at age 16years correlated positively with lumbar spine T\u2010score (r<jats:sup>2<\/jats:sup>\u00a0=\u00a00.439, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) and BMD (r<jats:sup>2<\/jats:sup>\u00a0=\u00a00.420, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) in women. The androstenedione\/testosterone ratio at age 16years correlated positively with lumbar spine Z\u2010score in women (r<jats:sup>2<\/jats:sup>\u00a0=\u00a00.284, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.024) and trochanter Z\u2010score in men (r<jats:sup>2<\/jats:sup>\u00a0=\u00a00.600, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.025).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher glucocorticoid doses seemed to cause lower BMD especially in women. Prednisolone appeared to have more detrimental effects on BMD than hydrocortisone. Higher glucocorticoid doses (lower androstenedione\/testosterone ratio) during adolescence may cause lower BMD in adulthood.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14149","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T14:23:36Z","timestamp":1577715816000},"page":"284-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Bone mineral density and fractures in congenital adrenal hyperplasia: Findings from the dsd\u2010LIFE study"],"prefix":"10.1111","volume":"92","author":[{"given":"Gabriel","family":"Riehl","sequence":"first","affiliation":[{"name":"Endocrinology in Charlottenburg Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Reisch","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV Ludwig\u2010Maximilians\u2010Universit\u00e4t Munich 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