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Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia

Background and objectives: 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...

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Autores principales: Navardauskaite, Ruta, Semeniene, Kristina, Sukys, Marius, Pridotkaite, Agne, Vanckaviciene, Aurika, Zilaitiene, Birute, Verkauskiene, Rasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031238/
https://www.ncbi.nlm.nih.gov/pubmed/35454339
http://dx.doi.org/10.3390/medicina58040500
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author Navardauskaite, Ruta
Semeniene, Kristina
Sukys, Marius
Pridotkaite, Agne
Vanckaviciene, Aurika
Zilaitiene, Birute
Verkauskiene, Rasa
author_facet Navardauskaite, Ruta
Semeniene, Kristina
Sukys, Marius
Pridotkaite, Agne
Vanckaviciene, Aurika
Zilaitiene, Birute
Verkauskiene, Rasa
author_sort Navardauskaite, Ruta
collection PubMed
description Background and objectives: 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. Methods: 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), p = 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). Results: 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, p < 0.001). Visceral adipose tissue (VAT) in grams was significantly higher in CAH females versus control females (467 (231–561) vs. 226 (164–295), p = 0.002). Elevated BP was identified in 34% of CAH patients (nine SW and two SV) and 12.5% (n = 4) of controls (p = 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 (r = −0.79, p = 0.036) in females with CAH. BMI, VAT, BP and HOMA-IR were not related to median cumulative HC dose equivalents. Conclusions: 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.
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spelling pubmed-90312382022-04-23 Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia Navardauskaite, Ruta Semeniene, Kristina Sukys, Marius Pridotkaite, Agne Vanckaviciene, Aurika Zilaitiene, Birute Verkauskiene, Rasa Medicina (Kaunas) Article Background and objectives: 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. Methods: 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), p = 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). Results: 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, p < 0.001). Visceral adipose tissue (VAT) in grams was significantly higher in CAH females versus control females (467 (231–561) vs. 226 (164–295), p = 0.002). Elevated BP was identified in 34% of CAH patients (nine SW and two SV) and 12.5% (n = 4) of controls (p = 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 (r = −0.79, p = 0.036) in females with CAH. BMI, VAT, BP and HOMA-IR were not related to median cumulative HC dose equivalents. Conclusions: 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. MDPI 2022-03-30 /pmc/articles/PMC9031238/ /pubmed/35454339 http://dx.doi.org/10.3390/medicina58040500 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Navardauskaite, Ruta
Semeniene, Kristina
Sukys, Marius
Pridotkaite, Agne
Vanckaviciene, Aurika
Zilaitiene, Birute
Verkauskiene, Rasa
Cardiometabolic Health in Adolescents and Young Adults with Congenital Adrenal Hyperplasia
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031238/
https://www.ncbi.nlm.nih.gov/pubmed/35454339
http://dx.doi.org/10.3390/medicina58040500
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