Evidence map›Paper›PMID 39533718›Full record

ArticleClinical and experimental pediatrics2025

Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency.

Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul

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Article in Clinical and experimental pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Pattara WiromratDivision of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Yutapong RaruenromDivision of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Phanpaphorn NamphaisanDivision of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Nantaporn WongsurawatDivision of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Ouyporn PanamontaDivision of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Chatlert PongchaiyakulDivision of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Funding

Khon Kaen University IN64118
6 · The paper itself

Abstract

backgroundIndividuals with 21-hydroxylase deficiency (21OHD) require lifelong glucocorticoid (GC) therapy, which increases their risk of fragility fractures. However, fractures in GC-treated individuals can occur at normal bone mineral density (BMD) levels, suggesting an alteration in the bone microarchitecture. PURPOSE: To evaluate trabecular bone microarchitecture and its changes in adolescents with 21OHD.

methodsWe enrolled 38 adolescents with 21OHD for whom complete clinical data and baseline and follow-up lumbar spine BMD (LSBMD) measurements were available. The mean duration was 1.5±0.6 years. Trabecular bone score (TBS), an indirect measurement of bone microarchitecture, was analyzed using iNsight software version 3.0. Impaired BMD and TBS were defined as z scores ≤ -1.5.

resultsAt baseline, participants (55% female; 68% salt- wasting type; mean age, 15.2±3.8 years; bone age, 17.5± 2.8 years; mean GC dose, 18.5±6.5 mg/m2/day) had the prevalence of impaired BMD and TBS of 5% and 18%, respectively. During follow-up, adolescents with 21OHD receiving prednisolone showed a lower annual percentage change in TBS than those who received hydrocortisone (P=0.028). A stepwise regression analysis showed that body mass index percentile (P<0.001) and testosterone concentration (P=0.002) were independent positive predictors of the baseline TBS z score, whereas prednisolone use was the only negative predictor of the annual percentage change in TBS (P=0.002).

conclusionAdolescents with 21OHD have a high prevalence of impaired bone microarchitecture. Furthermore, prednisolone therapy is associated with impaired bone microarchitecture development, suggesting that hydrocortisone may better preserve bone microarchitecture and should be considered the first-line treatment for this population.

Indexed as

21-hydroxylase deficiencyAdolescentsGlucocorticoidTrabecular bone score

Identifiers

PMID39533718
PMCPMC11884949

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