Endocrine Abstracts

Objectives: To assess bone mineral density (BMD) and body composition in adults with congenital adrenal hyperplasia (CAH).

Setting: Endocrine clinics in seventeen centres throughout the UK participating in CaHASE, a Society for Endocrinology project.

Study design and subjects: Cross-sectional survey of 203 adults with CAH (65 men, 138 women: median age 33 (range 18–70) years). Hundred and sixty six patients were classified as classic CAH and 37 as non-classic (based on age of diagnosis <10 years unless diagnosed as part of family screening), 129 people were receiving fludrocortisone. BMD measurements were available in 76 participants and body composition data in 202 participants. Body composition data were compared with data from the Health Survey for England 2003 (HSE) for men and women aged 25–74 years.

Outcome measures: BMD, weight, height, body mass index (BMI) and waist circumference.

Results: Mean (±s.d) lumbar and femoral BMD Z-scores were −0.34 (one-tailed t-test: 95%CI=−0.68 to 0.01, P=0.057) and −0.20 ±1.1 (95%CI=−0.45 to 0.05, P=0.119) respectively. The respective prevalence of osteopenia (BMD T-score ≤−1.0 to −2.5) and osteoporosis (BMD T-score≤−2.5) were 39.5% and 6.6% at the lumbar and 28.0% and 1.3% at the femoral sites. There were no significant correlations between BMD and age. Amongst all subjects, 37% were overweight (BMI ≥25–30 kg/m²) and 41% were obese (BMI ≥30 kg/m²), 49% had waist circumference greater than ‘Action Level 2’ (waist ≥102 cm in men, ≥88 cm in women). Compared to HSE participants, people with CAH were shorter, 10 cm for men and 6 cm for women (P<0.0001 for both), had higher BMI: 2.0 kg/m² for men (P=0.003) and 3.8 kg/m² for women (P<0.0001) and higher waist circumference for women (7 cm, P<0.0001) with no significant difference for men (P=0.33).

Conclusions: Adults with CAH are significantly shorter and more generally and centrally obese compared to the general population of England but BMD is not significantly different.

CaHASE are grateful to the Society for Endocrinology for the management of the project and The Clinical Endocrinology Trust for their financial support.