ElBakry Noura M, Khalf Asmaa, Ameen Mohamed, Mahgoob Mohamed
Pediatric, Faculty of Medicine, Minia University, Minia, EGY.
Clinical Pathology, Faculty of Medicine, Minia University, Minia, EGY.
Cureus. 2025 May 9;17(5):e83778. doi: 10.7759/cureus.83778. eCollection 2025 May.
Chronic glucocorticoid (cGC) therapy is a leading cause of drug-induced osteoporosis, often resulting in severe bone loss. Bone mineral density (BMD) is maintained by a dynamic balance between bone formation and resorption, regulated by various hormones, vitamin D, and cytokines. BMD is typically measured using dual-energy X-ray absorptiometry (DEXA). Tartrate-resistant acid phosphatase 5b (TRAP-5b) serves as a biomarker of bone resorption and is utilized to assess osteoclast activity.
This study aimed to evaluate BMD by measuring serum TRAP-5b levels in patients with congenital adrenal hyperplasia (CAH) receiving steroid therapy.
Forty patients with CAH underwent DEXA scans to assess BMD. Patients were then divided into two groups: one with normal BMD (n=14) and the other with abnormal BMD (n=26). Serum TRAP-5b levels were measured as a marker of bone turnover.
Children with CAH had significantly lower BMD in both the vertebrae and femoral neck. TRAP-5b levels were significantly higher in the abnormal BMD group (2.95 U/L) compared to the normal BMD group (p<0.001), indicating increased bone resorption in CAH.
Serum TRAP-5b activity may be a significant diagnostic and prognostic marker for bone disease in CAH.
长期糖皮质激素（cGC）治疗是药物性骨质疏松的主要原因，常导致严重的骨质流失。骨矿物质密度（BMD）通过骨形成与骨吸收之间的动态平衡来维持，这一平衡受多种激素、维生素D和细胞因子调节。BMD通常采用双能X线吸收法（DEXA）测量。抗酒石酸酸性磷酸酶5b（TRAP - 5b）作为骨吸收的生物标志物，用于评估破骨细胞活性。
本研究旨在通过测量接受类固醇治疗的先天性肾上腺皮质增生症（CAH）患者血清TRAP - 5b水平来评估BMD。
40例CAH患者接受DEXA扫描以评估BMD。然后将患者分为两组：一组BMD正常（n = 14），另一组BMD异常（n = 26）。测量血清TRAP - 5b水平作为骨转换的标志物。
CAH患儿的腰椎和股骨颈BMD显著降低。与BMD正常组相比，BMD异常组的TRAP - 5b水平显著更高（2.95 U/L）（p < 0.001），表明CAH患者骨吸收增加。
血清TRAP - 5b活性可能是CAH患者骨疾病的重要诊断和预后标志物。
