Impaired cognitive function in women with congenital adrenal hyperplasia.
BACKGROUND
Congenital adrenal hyperplasia (CAH) is a disorder with a wide spectrum of severity.


OBJECTIVE
The objective of this study was to investigate cognitive function in CAH women.


METHODS
This was a case-control study.


METHODS
This study was conducted at a tertiary center for pediatric endocrinology at the University Hospital of Copenhagen.


METHODS
Thirty-five Danish CAH women (age 17-51 yr) were included, and participation rate was 84%. Control women were recruited through the Danish Civil Registration System and matched on age and education.


METHODS
An abbreviated form of the Wechsler Adult Intelligence Scale was used, i.e. full-scale intelligence quotient (IQ; five of 11 subtests), which included three of six verbal IQ subtests and two of five performance IQ subtests.


RESULTS
A significantly lower IQ was found in CAH patients compared with controls with respect to mean full-scale IQ (84.5 vs. 99.1; P < 0.001), mean verbal IQ (86.6 vs. 97.3; P < 0.001), and mean performance IQ (85.7 vs. 101.3; P < 0.001). The salt-wasting CAH group had lower IQ scores than the simple-virilizing CAH group, which reached significance for mean total IQ (81.2 vs. 92.8, P = 0.04) and mean verbal IQ (84.7 vs. 95.5, P = 0.05), and additionally, lower scores than the late-onset CAH group, which reached significance for performance IQ (mean 81.5 vs. 96.2, P = 0.02).


CONCLUSIONS
Impaired cognitive function was observed in patients with CAH, especially in salt-wasting CAH. These intriguing findings may reflect adverse effects of hyponatremic episodes, suboptimal postnatal hormone replacement therapy or prenatal adrenal androgen excess, and the potential psychosocial consequences of the disorder.
Johannsen
Trine H
TH
University Department of Growth and Reproduction, GR-5064, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Ripa
Caroline P L
CP
Reinisch
June M
JM
Schwartz
Marianne
M
Mortensen
Erik L
EL
Main
Katharina M
KM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000523:psychology*; D000328:Adult; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007010:Hyponatremia / Q000209:etiology; D007361:Intelligence Tests; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones