Adiponectin levels are high in children with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency.
OBJECTIVE
It has been shown that adiponectin serves as an insulin-sensitizing adipokine. Serum concentrations of adiponectin are low in children with obesity, and increase with fat mass loss, indicating that adiponectin can serve as a biomarker. Since the prevalence of overweight and obesity is increased in children with congenital adrenal hyperplasia (CAH), our study aimed to evaluate serum levels of adiponectin in a cohort of CAH children and adolescents, and their associations with clinical parameters such as chronological age (CA), body mass index (BMI), Tanner stage (TS), medication and metabolic control.


METHODS
We studied 51 patients, aged between 5.6 and 19.6 years (median 11.8; 30 females, 21 males), cross-sectionally. All patients had genetically confirmed CAH and received standard steroid substitution therapy. Adiponectin was measured by an enzyme linked immunoassay. Since BMI SDS of the CAH cohort were significantly higher compared to the reference population, we built matched pairs with healthy Caucasian subjects from a normal representative cohort for sex, Tanner stage, chronologic age and BMI.


RESULTS
Adiponectin concentrations were significantly higher in CAH patients (median 11 microg/L) compared to the matched controls (6.7 microg/L, p < 0.0001). Correlation analyses in CAH patients revealed a significant inverse relationship between adiponectin and CA, TS, BMI, serum DHEAS and serum testosterone, but no correlation with hydrocortisone and fludrocortisone dosage.


CONCLUSIONS
Currently, the importance of the elevated adiponectin concentrations in CAH children for risk assessment is not clear. However, our data imply that besides adequate metabolic control of glucocorticoid substitution, a long-term follow-up of other metabolic markers of insulin resistance should be conducted in CAH patients.
Völkl
Thomas M K
TM
Division of Paediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
Simm
Diemud
D
Körner
Antje
A
Kiess
Wieland
W
Kratzsch
Jürgen
J
Dörr
Helmuth G
HG
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000150:complications; D015992:Body Mass Index; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D008297:Male; D008901:Mineralocorticoids / Q000494:pharmacology; D009765:Obesity / Q000209:etiology; D011279:Pregnanetriol / Q000652:urine; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism; D012885:Skinfold Thickness; D013255:Steroid 21-Hydroxylase / Q000378:metabolism*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
D052242:Adiponectin; D005938:Glucocorticoids; D008901:Mineralocorticoids; D011279:Pregnanetriol; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D013255:Steroid 21-Hydroxylase