title: Increased large artery intima media thickness in adolescents with either classical or non-classical congenital adrenal hyperplasia.
abstract: BACKGROUND
  Increased artery intima-media thickness (IMT) was found in adults with classical congenital adrenal hyperplasia (CAH). No data are available in patients with non-classical (NC) CAH.
  
  
  OBJECTIVE
  To evaluate IMT in adolescents with classical and NC CAH and to compare the results with those recorded in a control population.
  
  
  METHODS
  Eighteen adolescents with either classical (Subgroup A1) or NC CAH (Subgroup A2) were compared with 16 controls (Group B). All subjects underwent IMT ultrasonography measurement at different sites; results were correlated with clinical, metabolic, and insulin resistance (IR) data.
  
  
  RESULTS
  When compared with Group B, both subgroups exhibited higher IMT values at all sites. No differences were found between classical and NC CAH. Univariate analysis of factors impacting on IMT of CAH patients demonstrated that: a) abdominal aorta (AA) IMT was positively correlated with cumulative glucocorticoid doses, triglyceride serum levels, and diastolic blood pressure SD score and negatively with androstenendione and ACTH levels; b) common carotid (CC) IMT was positively associated with triglycerides and triglyceride/HDL ratio. At multiple regression analysis, the independent positive predictors of AA and CC IMT were respectively triglyceride levels and triglyceride/HDL ratio.
  
  
  CONCLUSIONS
  a) Even adolescents with NC CAH and not only those with classical form may be at higher risk of artery alterations; b) this risk is not necessarily associated with either obesity or waist/height ratio or dyslipidemia; c) an important role in the pathogenesis of artery alterations in CAH may be played by intermittent iatrogenic hypercortisolism and secondary IR.
authors.affiliation: Department for Pediatric Sciences, University of Messina, via Consolare Valeria, 98123 Messina-Gazzi, Italy. wasniewska@yahoo.it
authors.forename: M
authors.initials: M
authors.lastname: Wasniewska
authors.forename: A
authors.initials: A
authors.lastname: Balsamo
authors.forename: M
authors.initials: M
authors.lastname: Valenzise
authors.forename: A
authors.initials: A
authors.lastname: Manganaro
authors.forename: G
authors.initials: G
authors.lastname: Faggioli
authors.forename: S
authors.initials: S
authors.lastname: Bombaci
authors.forename: V
authors.initials: V
authors.lastname: Conti
authors.forename: M
authors.initials: M
authors.lastname: Ferri
authors.forename: T
authors.initials: T
authors.lastname: Aversa
authors.forename: A
authors.initials: A
authors.lastname: Cicognani
authors.forename: F
authors.initials: F
authors.lastname: De Luca
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000150:complications* / Q000473:pathology; D000328:Adult; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult