Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia
<i>Background and objectives:</i> Data on long-term cardiometabolic consequences in patients with congenital adrenal hyperplasia (CAH) are controversial. The aim of our study was to evaluate body mass index (BMI), body composition, blood pressure (BP) and insulin sensitivity in adolescen...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Online Access: | https://www.mdpi.com/1648-9144/58/4/500 |
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| author | Ruta Navardauskaite Kristina Semeniene Marius Sukys Agne Pridotkaite Aurika Vanckaviciene Birute Zilaitiene Rasa Verkauskiene |
| author_facet | Ruta Navardauskaite Kristina Semeniene Marius Sukys Agne Pridotkaite Aurika Vanckaviciene Birute Zilaitiene Rasa Verkauskiene |
| author_sort | Ruta Navardauskaite |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Data on long-term cardiometabolic consequences in patients with congenital adrenal hyperplasia (CAH) are controversial. The aim of our study was to evaluate body mass index (BMI), body composition, blood pressure (BP) and insulin sensitivity in adolescents and young adults with CAH in comparison with healthy controls. <i>Methods:</i> Thirty-two patients with classical CAH (13 males; mean of age 26.0 ± 7.1, years (14.0–37.3) were compared to 32 healthy sex and age-matched controls (13 males; mean of age 28.7 ± 4.6 years (14.1–37.2), <i>p</i> = 0.13). Body composition was evaluated in all subjects with DXA (Hologic Inc., Bedford, MA, USA). Elevated BP was defined as BP > 95th percentile in adolescents, and >140/90 mmHg in adults. Comparisons between the two groups were adjusted for age, gender, pubertal stage and height. An oral glucose tolerance test was performed, and fasting insulin levels were evaluated. Insulin sensitivity was determined using a homeostasis model assessment of insulin resistance index (HOMA-IR). <i>Results:</i> The median BMI was significantly higher in subjects with CAH (1.63 (0.3–2.4) SDS and 0.41 (−0.63–1.19) SDS, respectively, <i>p</i> < 0.001). Visceral adipose tissue (VAT) in grams was significantly higher in CAH females versus control females (467 (231–561) vs. 226 (164–295), <i>p</i> = 0.002). Elevated BP was identified in 34% of CAH patients (nine SW and two SV) and 12.5% (<i>n</i> = 4) of controls (<i>p</i> = 0.038). Impaired fasting glycemia was detected in one SW CAH patient and impaired glucose tolerance in three SV CAH patients; normal glucose tolerance was found in all controls. A strong positive correlation was found between median cumulative hydrocortisone (HC) dose equivalents and LDL-cholesterol and a negative association with lean body mass (<i>r</i> = −0.79, <i>p</i> = 0.036) in females with CAH. BMI, VAT, BP and HOMA-IR were not related to median cumulative HC dose equivalents. <i>Conclusions:</i> CAH patients had higher BMI, VAT and frequency of elevated BP compared to controls. Doses of glucocorticoids were related directly to LDL-cholesterol and inversely to lean body mass in CAH females, but not associated with body composition, insulin sensitivity and BP in the whole cohort of CAH patients. |
| first_indexed | 2024-03-09T13:20:53Z |
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| issn | 1010-660X 1648-9144 |
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| last_indexed | 2024-03-09T13:20:53Z |
| publishDate | 2022-03-01 |
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| spelling | doaj.art-ebb66cbb00c3401d950bf41a8a7704822023-11-30T21:30:19ZengMDPI AGMedicina1010-660X1648-91442022-03-0158450010.3390/medicina58040500Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal HyperplasiaRuta Navardauskaite0Kristina Semeniene1Marius Sukys2Agne Pridotkaite3Aurika Vanckaviciene4Birute Zilaitiene5Rasa Verkauskiene6Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaDepartment of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaDepartment of Genetics and Molecular Medicine, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaDepartment of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaDepartment of Nursing, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaInsitute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, LithuaniaInsitute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania<i>Background and objectives:</i> Data on long-term cardiometabolic consequences in patients with congenital adrenal hyperplasia (CAH) are controversial. The aim of our study was to evaluate body mass index (BMI), body composition, blood pressure (BP) and insulin sensitivity in adolescents and young adults with CAH in comparison with healthy controls. <i>Methods:</i> Thirty-two patients with classical CAH (13 males; mean of age 26.0 ± 7.1, years (14.0–37.3) were compared to 32 healthy sex and age-matched controls (13 males; mean of age 28.7 ± 4.6 years (14.1–37.2), <i>p</i> = 0.13). Body composition was evaluated in all subjects with DXA (Hologic Inc., Bedford, MA, USA). Elevated BP was defined as BP > 95th percentile in adolescents, and >140/90 mmHg in adults. Comparisons between the two groups were adjusted for age, gender, pubertal stage and height. An oral glucose tolerance test was performed, and fasting insulin levels were evaluated. Insulin sensitivity was determined using a homeostasis model assessment of insulin resistance index (HOMA-IR). <i>Results:</i> The median BMI was significantly higher in subjects with CAH (1.63 (0.3–2.4) SDS and 0.41 (−0.63–1.19) SDS, respectively, <i>p</i> < 0.001). Visceral adipose tissue (VAT) in grams was significantly higher in CAH females versus control females (467 (231–561) vs. 226 (164–295), <i>p</i> = 0.002). Elevated BP was identified in 34% of CAH patients (nine SW and two SV) and 12.5% (<i>n</i> = 4) of controls (<i>p</i> = 0.038). Impaired fasting glycemia was detected in one SW CAH patient and impaired glucose tolerance in three SV CAH patients; normal glucose tolerance was found in all controls. A strong positive correlation was found between median cumulative hydrocortisone (HC) dose equivalents and LDL-cholesterol and a negative association with lean body mass (<i>r</i> = −0.79, <i>p</i> = 0.036) in females with CAH. BMI, VAT, BP and HOMA-IR were not related to median cumulative HC dose equivalents. <i>Conclusions:</i> CAH patients had higher BMI, VAT and frequency of elevated BP compared to controls. Doses of glucocorticoids were related directly to LDL-cholesterol and inversely to lean body mass in CAH females, but not associated with body composition, insulin sensitivity and BP in the whole cohort of CAH patients.https://www.mdpi.com/1648-9144/58/4/500CAHcongenital adrenal hyperplasiacardiometabolicinsulin resistancegenotype and phenotype correlation |
| spellingShingle | Ruta Navardauskaite Kristina Semeniene Marius Sukys Agne Pridotkaite Aurika Vanckaviciene Birute Zilaitiene Rasa Verkauskiene Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia Medicina CAH congenital adrenal hyperplasia cardiometabolic insulin resistance genotype and phenotype correlation |
| title | Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia |
| title_full | Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia |
| title_fullStr | Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia |
| title_full_unstemmed | Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia |
| title_short | Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia |
| title_sort | cardiometabolic health in adolescents and young adults with congenital adrenal hyperplasia |
| topic | CAH congenital adrenal hyperplasia cardiometabolic insulin resistance genotype and phenotype correlation |
| url | https://www.mdpi.com/1648-9144/58/4/500 |
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