Endocrine Abstracts

Introduction: Endocrinopathies can cause secondary osteoporosis and little is known of the extent of this condition in young adults.

Methods: In order to assess the bone health in endocrinopathies in young adults, a retrospective analysis of 25 transitional clinic patients who underwent dual energy X-ray absorptiometry (DEXA scan) was made using case notes and the hospital database.

Results: Twenty-three patients were male and the mean age was 19 years. Sixteen patients had GH deficiency, of which 13 had replacement during childhood, while other 3 are still on GH. 8/25 had hypogonadism, and are on sex hormone replacement. 4/25 were on long-term steroids. Endocrinopathies were due to post-operative radiotherapy for brain tumours in 12/25, cranial and total body irradiation following Leukaemia in 4/25, Histiocytosis X in 2/25 and Klinefelter’s syndrome in 2/25.

One (4%) patient had osteoporosis with a significant spinal fracture history and low bone mineral density (BMD). 19/25 (76%) patients who had a DEXA scan had reduced BMD. Z-scores were not available in 21 patients due to absence of age-matched controls. Logistical regression analysis showed that the reduction in BMD is more prevalent in patients with GH deficiency (P=0.087). 15/20 (75%) patients are on calcium, vitamin D3 and bisphosphonates after confirmation of low bone mineral density.

Conclusions: Low bone mineral density is present in 2/3rds of at risk patients in our transitional endocrine clinic. The patients with GH insufficiency are at higher risk of reduced BMD, even if they are treated with GH in childhood. It’s still not clear whether replacement of the deficient hormone along with calcium and vitamin D3 supplementation is adequate or whether additional bisphosphonate therapy with potential side-effects is required.