{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:47:59Z","timestamp":1781801279068,"version":"3.54.5"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The effects of long-term glucocorticoid (GC) treatment on bone mineral density (BMD) in patients with congenital adrenal hyperplasia (CAH) remain controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This cross-sectional study aimed to evaluate BMD in relation to genotype, growth, vitamin D status, cumulative GC doses, and other relevant factors in youths with CAH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty-two patients with classical CAH (13 males; mean age 26.0\u2009\u00b1\u20097.1\u2005years) were compared with 32 healthy controls matched by age and sex. BMD was measured using dual-energy x-ray absorptiometry, and statistical analyses, including the Mann\u2013Whitney <jats:italic>U<\/jats:italic>-test and Spearman's correlation coefficient, were performed to evaluate differences and associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median whole-body and lumbar BMD <jats:italic>Z<\/jats:italic>-scores were similar between CAH patients and controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.27 and 0.15, respectively). Low bone density was observed in 12.5% of CAH patients and 18.75% of controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.5), and osteoporosis was confirmed in 12.5% of CAH patients and 0% of controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). BMD did not correlate with cumulative GC doses, estradiol, renin, phosphate, sodium levels, or anthropometric parameters in CAH patients. There was no significant difference in BMD between severe and non-severe genotypes of CAH. However, a positive correlation was found between the whole-body BMD <jats:italic>Z<\/jats:italic>-score and growth velocity during infancy (<jats:italic>r<\/jats:italic>\u2009=\u20090.776, <jats:italic>p<\/jats:italic>\u2009=\u20090.021) in CAH patients. Vitamin D deficiency was noted in 56.25% of CAH patients, although vitamin D levels did not correlate with BMD or genotype. No history of bone fractures was reported among study participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CAH patients are at risk of developing osteoporosis, but in this study, BMD <jats:italic>Z<\/jats:italic>-scores were not associated with cumulative GC doses. The study did not identify an association between genotype and BMD. Poor growth during infancy was linked to decreased BMD in adulthood.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1456679","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:39:55Z","timestamp":1728362395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Bone mineral density determinants in adolescents and young adults with congenital adrenal 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