Department of Endocrinology, Ankara Children's Hematology and Oncology Training Hospital, Turkey.
Turk J Med Sci. 2014;44(1):109-14. doi: 10.3906/sag-1301-114.
To determine the prevalence of and risk factors for decreased bone mineral density (BMD) and vitamin D deficiency in children and adolescents with congenital adrenal hyperplasia (CAH).
This study was conducted on 30 girls and 22 boys with CAH (age range = 5-20 years) with median age of 12.0 years. BMD values of lumbar vertebras (L1-L4), which were determined by dual-energy X-ray absorptiometry, were used to calculate z-scores according to chronological age. A serum 25-hydroxyvitamin D level of <15 ng/mL was considered as indicative of vitamin D deficiency.
Mean vitamin D level was 14.8 ng/mL in the whole group. Twenty-seven (51.9%) children had vitamin D deficiency and it was more prevalent during pubertal ages. Vitamin D levels were found to be significantly lower in pubertal females. BMD z-score was below -1 standard deviation in 40.1% of cases with significantly higher mean age and lower vitamin D levels.
Decreased BMD z-score and vitamin D deficiency were common in these children with CAH. Vitamin D levels were significantly lower in girls and pubertal children. Decreased BMD z-score was related to older age and lower levels of vitamin D. Periodical controls of vitamin D status and vitamin D supplementation were recommended in these cases, whenever required.
确定患有先天性肾上腺增生症（CAH）的儿童和青少年骨密度（BMD）降低和维生素 D 缺乏的患病率和危险因素。
本研究共纳入 30 名女孩和 22 名男孩 CAH 患者（年龄 5-20 岁，中位数 12.0 岁）。采用双能 X 线吸收法测定腰椎（L1-L4）的 BMD 值，根据实际年龄计算 z 评分。血清 25-羟维生素 D 水平<15ng/mL 被认为存在维生素 D 缺乏。
全组平均维生素 D 水平为 14.8ng/mL。27 名（51.9%）儿童存在维生素 D 缺乏，青春期时更为常见。青春期女性的维生素 D 水平明显较低。40.1%的儿童 BMD z 评分低于-1 个标准差，且平均年龄较大，维生素 D 水平较低。
患有 CAH 的这些儿童中，BMD z 评分降低和维生素 D 缺乏较为常见。女孩和青春期儿童的维生素 D 水平明显较低。BMD z 评分降低与年龄较大和维生素 D 水平较低有关。建议此类患者定期检查维生素 D 状态并按需补充维生素 D。
