Evidence map›Paper›PMID 24862755›Full record

ArticleClinical endocrinology2015

Cortical bone mineral density in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

Diala El-Maouche, Suzanne Collier, Mala Prasad, James C Reynolds, Deborah P Merke

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical endocrinology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Long-term Complications and Testicular Adrenal Rest Tumors in Congenital Adrenal HyperplasiaJournal of clinical research in pediatric endocrinology · 2025
    Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Article
  11. Long-Term Outcomes of Congenital Adrenal Hyperplasia.Endocrinology and metabolism (Seoul, Korea) · 2022
    Review
  12. Article
  13. Article
  14. Review
  15. Review
  16. Observational
  17. Review
  18. Article
  19. Real-world impact of glucocorticoid replacement therapy on bone mineral density: retrospective experience of a large single-center CAH cohort spanning 24 years.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Diala El-MaoucheNational Institute of Dental and Craniofacial Research, National Institutes of Health (NIH), Bethesda, MD, USA; National Institutes of Health (NIH) Clinical Center, Bethesda, MD, USA.
Suzanne Collier
Mala Prasad
James C Reynolds
Deborah P Merke
National Institutes of Health Clinical Center · USEunice Kennedy Shriver National Institute of Child Health and Human Development · US

Funding

Natural History Study of Patients with Excess AndrogenZIAHD008934 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI MERKE, DEBORAH · 2013 to 2021
$238k
Continuous Subcutaneous Hydrocortisone Infusion Treatment for CAHZIAHD008932 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI MERKE, DEBORAH · 2013 to 2019
$34k
Intramural NIH HHS ZIA HD008934
6 · The paper itself

Abstract

backgroundPrior studies reveal that bone mineral density (BMD) in congenital adrenal hyperplasia (CAH) is mostly in the osteopaenic range and is associated with lifetime glucocorticoid dose. The forearm, a measure of cortical bone density, has not been evaluated.

objectiveWe aimed to evaluate BMD at various sites, including the forearm, and the factors associated with low BMD in CAH patients.

methodsEighty CAH adults (47 classic, 33 nonclassic) underwent dual-energy-x-ray absorptiometry and laboratory and clinical evaluation. BMD Z-scores at the AP spine, total hip, femoral neck, forearm and whole body were examined in relation to phenotype, body mass index, current glucocorticoid dose, average 5-year glucocorticoid dose, vitamin D, 17-hydroxyprogesterone, androstenedione, testosterone, dehydroepiandrosterone and dehydroepiandrosterone sulphate (DHEAS).

resultsReduced BMD (T-score <-1 at hip, spine, or forearm) was present in 52% and was more common in classic than nonclassic patients (P = 0·005), with the greatest difference observed at the forearm (P = 0·01). Patients with classic compared to nonclassic CAH, had higher 17-hydroxyprogesterone (P = 0·005), lower DHEAS (P = 0·0002) and higher non-traumatic fracture rate (P = 0·0005). In a multivariate analysis after adjusting for age, gender, height standard deviation, phenotype and cumulative glucocorticoid exposure, higher DHEAS was independently associated with higher BMD at the spine, radius and whole body.

conclusionClassic CAH patients have lower BMD than nonclassic patients, with the most affected area being the forearm. This first study of forearm BMD in CAH patients suggests that low DHEAS may be associated with weak cortical bone independent of glucocorticoid exposure.

Indexed as

Absorptiometry, PhotonAdrenal Hyperplasia, CongenitalAdultBone DensityFemaleFemur NeckForearmGlucocorticoidsHumansMaleMiddle AgedMultivariate AnalysisPelvic BonesSpineYoung AdultGlucocorticoids

Identifiers

PMID24862755
PMCPMC4242797
OpenAlexW2088550987

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.