Endocrine Abstracts

Introduction: Previous audits demonstrated low bone mineral density (BMD) in adolescent patients with hormone deficiencies. We wanted to ascertain if gender had any relationship with the development of low BMD.

Method: A retrospective analysis of 42 Transitional clinic patients who underwent DEXA scanning was made using case notes and hospital systems. Follow-up data was gathered as previous audit of 25 transitional patients had shown a significant number to have low BMD.

Results: A total of 42 patient records were accessed, of these 33 patients were male. Mean age for both genders was 21. Hormonal deficiencies included: childhood growth hormone deficiency n=22 (17 male), hypogonadism n=20 (5 female), steroid deficient and on long-term replacement n=8 (6 male). Thirteen patients (n=4 female) had co-existing endocrinopathies with n=5 (4 male) having deficiencies of all three hormones.

Endocrinopathies were due to brain tumour/ injury, histocytosis, leukaemia, CAH, BPES syndrome, primary hypogonadism, thallasaemia, hypogonadotrophic hypogonadism.

Age range at baseline was 16–21 years for male and 17–20 years for females.

Twenty males (60.6%) and n=7 (77.7%) females had low BMD at baseline scans. There were 16 patients (n=13 male) in whom only lumbar spine was reported due to absence of age match control for femoral neck.

Of the 27 patients found to have low baseline BMD’s, n=15 (75%) males and n=3 (42.8%) females were treated with combination of bisphosphonate and calcium/vit D supplements. n=1 female and n=1 male received calcium/vit D only; 8 (n=4 female) were untreated.

14 patients with low baseline BMD’s (n=3 female) had follow-up scans. In the group treated with combination of bisphosphonate and calcium/vit D supplement, 9 (n=8 male) demonstrated improved BMD when rescanned. n=2 male and n=1 female showed no improvement and n=2 (1 male) showed reduction in BMD.

Three male patients had normal baseline BMD’s and there was no change in the intervening 2–4 years.

Conclusion: Two thirds of the patients attending Transitional clinic were found to have low BMD’s. Baseline scans would suggest that females in this age group have a higher risk of developing low BMD. In those patients who received combination of bisphosphonate and calcium/vit D; 64% male patients and 33% female patients showed improvement in BMD when rescanned.