Obesity and familial predisposition are significant determining factors of an adverse metabolic profile in young patients with congenital adrenal hyperplasia.
OBJECTIVE
Glucocorticoid (GC) therapy is known to predispose to an adverse metabolic profile. Therefore, we investigated the prevalence of obesity and metabolic syndrome (MetS) in young patients with congenital adrenal hyperplasia (CAH) and to correlate this prevalence with GC treatment and family history.


METHODS
The study population consisted of 33 young CAH patients who received cortisone acetate during their growth periods; those who were salt wasters also received fludrocortisone. Obesity was defined by a body mass index (BMI) >95th percentile and MetS by the National Cholesterol Education Program Third Adult Treatment Panel modified criteria. Each patient's familial history of MetS components was assessed. The impact of GC therapy on the metabolic profile was analyzed by comparing CAH patients with BMI z-score-matched controls.


RESULTS
MetS and obesity were observed in 12.1 and 30.3% of the CAH patients, respectively, both of which were higher than in the reference population. A positive family history of MetS was found to be more prevalent in the obese patients compared with the nonobese CAH patients, and similar findings were observed for the controls. The metabolic profile did not differ between the CAH patients and matched subjects.


CONCLUSIONS
CAH patients presented a higher prevalence of obesity and MetS, which were not correlated with the GC treatment. This study suggests that obesity and familial predisposition are significant determining factors for an adverse metabolic profile in CAH patients.
Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular (LIM/42), Disciplina de Endocrinologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
Ricardo P P
RP
Moreira
Sandra M
SM
Villares
Guiomar
G
Madureira
Berenice B
BB
Mendonca
Tânia A S S
TA
Bachega
D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000453:epidemiology / Q000378:metabolism*; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003348:Cortisone / Q000031:analogs & derivatives / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009765:Obesity / Q000378:metabolism*; D015995:Prevalence
D005938:Glucocorticoids; D003348:Cortisone