title: Cardiovascular risk factors and increased carotid intima-media thickness in young patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
abstract: OBJECTIVE
  Increased arterial intima-media thickness has been observed in adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD). CAH has also been associated with obesity, insulin resistance, and hypertension. The aim of the present study was to compare youths with CAH with healthy, normal-weight individuals, evaluating carotid intima-media thickness (CIMT) and indicative factors of cardiovascular risk to seek for abnormalities in the CAH group.
  
  
  METHODS
  Clinical, biochemical, and ultrasonographic evaluations, according to published criteria, were performed in 113 subjects (5 to 20 years old): 40 patients with 21-OHD and 73 healthy individuals matched for gender, pubertal status, and age.
  
  
  RESULTS
  Most CAH patients were female (80%), salt-losers (72.5%), and pubescent (80%); 10 (25%) patients were overweight. An increase in CIMT was observed both on the right (p = 0.0240) and left (p = 0.0003) sides in 38 CAH patients compared with the healthy individuals. The body mass index, BMI/age Z score, and systolic blood pressure (SBP) were higher in patients compared with controls (p < 0.000 and p = 0.0219, respectively).
  
  
  CONCLUSIONS
  Findings of increased CIMT, BMI, and SBP in young patients with 21-OHD indicate the need for early identification and intervention regarding cardiovascular risk. Validating these findings might result in improved therapeutic approaches for children with 21-OHD in the future.
authors.affiliation: Divisão de Endocrinologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG.
authors.forename: Tânia Maria Barreto
authors.initials: TM
authors.lastname: Rodrigues
authors.affiliation: Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Cristina Botelho
authors.initials: CB
authors.lastname: Barra
authors.affiliation: Departamento de Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Jovita Lane Soares
authors.initials: JL
authors.lastname: Santos
authors.affiliation: Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Eugênio Marcos Andrade
authors.initials: EM
authors.lastname: Goulart
authors.affiliation: Departamento de Nutrição, Faculdade de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Adaliene Versiani Matos
authors.initials: AV
authors.lastname: Ferreira
authors.affiliation: Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Ivani Novato
authors.initials: IN
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000000981:diagnostic imaging* / Q000378:metabolism; D062186:Arterial Pressure / Q000502:physiology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000000981:diagnostic imaging; D012307:Risk Factors; D055815:Young Adult