title: Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
abstract: BACKGROUND
  In congenital adrenal hyperplasia (CAH), long-term glucocorticoid treatment coupled with increased androgens may lead to undesirable metabolic effects. The aim of our report was to determine the prevalence of metabolic abnormalities and cardiovascular risk factors in a population of adult patients with CAH due to 21 hydroxylase deficiency.
  
  
  METHODS
  Twenty-six patients (11 males and 15 females, mean age ± SD=27.4±8.2 years) were recruited. Anthropometry, body composition, metabolic parameters and cardiovascular risk factors were studied.
  
  
  RESULTS
  Obesity (overweight included) was noted in 16 patients (61.5%), with android distribution in all cases. Bioelectrical impedance showed increased body fat mass in 12 patients (46.1%). Lipid profile alterations and carbohydrate metabolism disorders were detected in seven (26.9%) and five (19.2%) patients respectively. Moderate hepatic cytolysis, associated with hepatic steatosis, was found in one patient. Seven patients (27%) had insulin resistance. Ambulatory blood pressure monitoring showed abnormalities in six patients (23%). Increased carotid intima media thickness was found in 14 patients (53.8%).
  
  
  CONCLUSIONS
  Adult CAH patients tend to have altered metabolic parameters and a higher prevalence of cardiovascular risk factors. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.
authors.affiliation: Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: Mouna Feki
authors.initials: MF
authors.lastname: Mnif
authors.forename: Mahdi
authors.initials: M
authors.lastname: Kamoun
authors.forename: Fatma
authors.initials: F
authors.lastname: Mnif
authors.forename: Nadia
authors.initials: N
authors.lastname: Charfi
authors.forename: Basma Ben
authors.initials: BB
authors.lastname: Naceur
authors.forename: Nozha
authors.initials: N
authors.lastname: Kallel
authors.forename: Nabila
authors.initials: N
authors.lastname: Rekik
authors.forename: Zainab
authors.initials: Z
authors.lastname: Mnif
authors.forename: Mohamed Habib
authors.initials: MH
authors.lastname: Sfar
authors.forename: Mohamed Tahar
authors.initials: MT
authors.lastname: Sfar
authors.forename: Mongia
authors.initials: M
authors.lastname: Hachicha
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abid