Cargando…

Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

There is a lack of studies regarding the long-term outcomes of Asian adults with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We hypothesized that adults with CAH are at higher metabolic risk than their age-, and sex-matched controls. We further investigated the lon...

Descripción completa

Detalles Bibliográficos
Autores principales: Lim, Seung Gyun, Lee, Young Ah, Jang, Han Na, Kong, Sung Hye, Ahn, Chang Ho, Kim, Sang Wan, Shin, Choong Ho, Kim, Jung Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547732/
https://www.ncbi.nlm.nih.gov/pubmed/34712205
http://dx.doi.org/10.3389/fendo.2021.761258
_version_ 1784590437898518528
author Lim, Seung Gyun
Lee, Young Ah
Jang, Han Na
Kong, Sung Hye
Ahn, Chang Ho
Kim, Sang Wan
Shin, Choong Ho
Kim, Jung Hee
author_facet Lim, Seung Gyun
Lee, Young Ah
Jang, Han Na
Kong, Sung Hye
Ahn, Chang Ho
Kim, Sang Wan
Shin, Choong Ho
Kim, Jung Hee
author_sort Lim, Seung Gyun
collection PubMed
description There is a lack of studies regarding the long-term outcomes of Asian adults with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We hypothesized that adults with CAH are at higher metabolic risk than their age-, and sex-matched controls. We further investigated the long-term health outcome-related factors in adults with CAH. We compared metabolic risk between adults with CAH (71 men, 93 women) and age-, and sex-matched controls (190 men, 261 women) from the Korean National Health and Nutrition Examination Survey data. The presence of obesity, testicular adrenal rest tumors (TARTs), and menstrual irregularity was assessed. Hormone status and treatment regimens were compared according to the presence of adverse outcomes. The median age was 27.0 y and 28.0 y for men and women, respectively. Adults with CAH had a higher waist circumference (88.0 vs. 82.3 cm in men, and 83.5 vs. 72.3 cm in women), and blood pressure (125.0 vs. 113.0 mmHg in men, and 120.0 vs. 104.0 mmHg in women) than age- and sex-matched controls (P<0.05 for all). The 2.7-fold increased risk for hypertension (men) and 2.0-fold increased risk for obesity (women) was significant in patients with CAH (P<0.05 for both). Obese adults with CAH showed significantly higher adrenal limb thicknesses (men) and 17-hydroxyprogesterone and dehydroepiandrosterone sulfate levels (women) (P<0.05 for both). TARTs occurred in 58.1% of men and did not differ by hormone or treatment regimen. Irregular menstruation was observed in 57.1% of women, with higher dehydroepiandrosterone sulfate levels in those with irregular periods. Adults with CAH had a higher metabolic risk than the general population. Poor disease control may increase their risk of metabolic morbidity and menstrual irregularity.
format Online
Article
Text
id pubmed-8547732
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-85477322021-10-27 Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency Lim, Seung Gyun Lee, Young Ah Jang, Han Na Kong, Sung Hye Ahn, Chang Ho Kim, Sang Wan Shin, Choong Ho Kim, Jung Hee Front Endocrinol (Lausanne) Endocrinology There is a lack of studies regarding the long-term outcomes of Asian adults with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We hypothesized that adults with CAH are at higher metabolic risk than their age-, and sex-matched controls. We further investigated the long-term health outcome-related factors in adults with CAH. We compared metabolic risk between adults with CAH (71 men, 93 women) and age-, and sex-matched controls (190 men, 261 women) from the Korean National Health and Nutrition Examination Survey data. The presence of obesity, testicular adrenal rest tumors (TARTs), and menstrual irregularity was assessed. Hormone status and treatment regimens were compared according to the presence of adverse outcomes. The median age was 27.0 y and 28.0 y for men and women, respectively. Adults with CAH had a higher waist circumference (88.0 vs. 82.3 cm in men, and 83.5 vs. 72.3 cm in women), and blood pressure (125.0 vs. 113.0 mmHg in men, and 120.0 vs. 104.0 mmHg in women) than age- and sex-matched controls (P<0.05 for all). The 2.7-fold increased risk for hypertension (men) and 2.0-fold increased risk for obesity (women) was significant in patients with CAH (P<0.05 for both). Obese adults with CAH showed significantly higher adrenal limb thicknesses (men) and 17-hydroxyprogesterone and dehydroepiandrosterone sulfate levels (women) (P<0.05 for both). TARTs occurred in 58.1% of men and did not differ by hormone or treatment regimen. Irregular menstruation was observed in 57.1% of women, with higher dehydroepiandrosterone sulfate levels in those with irregular periods. Adults with CAH had a higher metabolic risk than the general population. Poor disease control may increase their risk of metabolic morbidity and menstrual irregularity. Frontiers Media S.A. 2021-10-12 /pmc/articles/PMC8547732/ /pubmed/34712205 http://dx.doi.org/10.3389/fendo.2021.761258 Text en Copyright © 2021 Lim, Lee, Jang, Kong, Ahn, Kim, Shin and Kim https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Lim, Seung Gyun
Lee, Young Ah
Jang, Han Na
Kong, Sung Hye
Ahn, Chang Ho
Kim, Sang Wan
Shin, Choong Ho
Kim, Jung Hee
Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title_full Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title_fullStr Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title_full_unstemmed Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title_short Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
title_sort long-term health outcomes of korean adults with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547732/
https://www.ncbi.nlm.nih.gov/pubmed/34712205
http://dx.doi.org/10.3389/fendo.2021.761258
work_keys_str_mv AT limseunggyun longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT leeyoungah longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT janghanna longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT kongsunghye longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT ahnchangho longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT kimsangwan longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT shinchoongho longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency
AT kimjunghee longtermhealthoutcomesofkoreanadultswithclassiccongenitaladrenalhyperplasiadueto21hydroxylasedeficiency