the effect of glucocorticoid therapy on bone mineral density in children and adolescents with congenital adrenal hyperplasia

Background: this study aimed to investigate the effect of the treatment with corticosteroids, and to identify different factor associating to the bone density of the spine and femoral head increases. to this end, the bone mineral densities of the spine and femoral head in children suffering from different types of congenital adrenal hyperplasia were assessed; and their association with some other factors, along with the effects of the treatment was investigated. method: this retrospective and descriptive cohort study was done in iran from 2020 until 2021, on 44 patients with mean age of 10 years old. forty-four patients, including 18 males and 26 females with a mean age of 10 years were enrolled in this study. they were treated with corticosteroids with a physiological dose of 15-20 mg/m2 since infancy. a questionnaire was completed by patients and their parents admitted to the endocrinology clinic of imam reza hospital of mashhad. the patients' bone density was then measured, and the association with different factors, such as age, gender, height, weight, type of cah, type and duration of receiving corticosteroids, the 17-hydroxyprogesterone level, bone activity markers, vitamin d level, and puberty stage, was analyzed, using spss software. result: no significant correlation between the bone density level and variables such as the duration and dose of corticosteroid consumption, age, sex, time of diagnosis, 17hydroxyprogesterone level, calcium, and phosphorus, was found. other variables such as height, weight, puberty stage, and vitamin d levels were found to play a significant role in determining the bone density level.conclusion: it is highly recommended to consider the side effects and complications when starting treatment with corticosteroids in patients with cah. bone densitometry should regularly be done, osteoporosis prophylaxis should be considered using weight-bearing exercises and calcium and vitamin d supplements, and the level of vitamin d should be monitored.