{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:47:51Z","timestamp":1781801271095,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Prognostic biomarkers for monitoring bone health in adolescents with 21\u2010hydroxylase deficiency (21OHD) are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess associations between concentrations of baseline bone turnover markers (BTMs) including osteocalcin (OC) and type\u2010I collagen C\u2010terminal telopeptide (CTX) and changes in lumbar spine bone mineral density (LSBMD) in adolescents with classic 21OHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Designs and patients<\/jats:title><jats:p>A retrospective\u2010prospective study of 33 adolescents with classic 21OHD who had baseline data for LSBMD, bone age (BA), and BTM concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BTM concentrations were converted into z\u2010scores according to BA. We measured LSBMD at the follow\u2010up study visit and calculated the annual percentage change in LSBMD (%\u2206LSBMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, participants (55% female, 79% Tanner 5) had mean (\u00b1SD) age of 14.6\u2009\u00b1\u20093.6\u2009years, BA 16.7\u2009\u00b1\u20092.9\u2009years, and average glucocorticoid (GC) dose 17.3\u2009\u00b1\u20095.6\u2009mg\/m<jats:sup>2<\/jats:sup>\/day of hydrocortisone equivalent. The mean follow\u2010up duration was 14.4\u2009\u00b1\u20095.6\u2009months. Median (Q1\u2013Q3) %\u2206LSBMD was 3.6% (0\u20138.5)\/year. %\u2206LSBMD was similar among genders or 21OHD subtypes. Prednisolone versus hydrocortisone replacement resulted in lower %\u2206LSBMD (<jats:italic>p<\/jats:italic>\u2009=\u2009.004). %\u2206LSBMD was increased across tertiles of CTX z\u2010score (<jats:italic>p<\/jats:italic>\u2009=\u2009.014). %\u2206LSBMD correlated negatively with GC dose (<jats:italic>p<\/jats:italic>\u2009=\u2009.01) and positively with CTX and OC z\u2010scores (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). In regression analyses, only CTX z\u2010score positively associated with %\u2206LSBMD (<jats:italic>p<\/jats:italic>\u2009=\u2009.003), adjusting for sex, BA, body mass index, testosterone, 25\u2010hydroxyvitamin D, and GC type and dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher GC dose and the use of prednisolone were associated with decreased LSBMD accrual in adolescents with 21OHD. CTX z\u2010score independently associated with LSBMD accrual, suggesting its potential for prognostic bone biomarker.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14809","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T05:27:40Z","timestamp":1660022860000},"page":"462-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Elevated bone turnover markers predict bone mineral density accrual in adolescents with 21\u2010hydroxylase deficiency"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1070-6774","authenticated-orcid":false,"given":"Pattara","family":"Wiromrat","sequence":"first","affiliation":[{"name":"Section of Endocrinology, Department of Pediatrics, Faculty of Medicine Khon Kaen University Khon Kaen 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