title: Carotid Intima-Media Thickness Is Associated with Increased Androgens in Adolescents and Young Adults with Classical Congenital Adrenal Hyperplasia.
abstract: OBJECTIVE
  Youth with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency develop cardiovascular disease (CVD) risk factors of obesity and hypertension. Carotid intima-media thickness (CIMT), a marker of CVD risk, is increased in CAH young adults. We examined CIMT and its relationship with androgens and obesity in adolescents/young adults with CAH.
  
  
  METHODS
  Twenty CAH subjects (age 16 ± 3.3 years, 50% female) and 20 matched controls were studied cross-sectionally. Eight additional obese patients with CAH were included in within-group comparisons. CIMT by high-resolution ultrasound, androgens, anthropometry, bone age (BA), and metabolic/inflammatory markers were assessed.
  
  
  RESULTS
  Within the CAH group, CIMT correlated with 17-hydroxyprogesterone (r = 0.48, p < 0.05) and androstenedione (r = 0.46, p < 0.05), and was greater in obese subjects. CIMT was greater in CAH males than females, but similar among CAH females with advanced BA, CAH males with normal BA, and control males. There was no difference in CIMT between CAH and controls, although high-density lipoprotein was inversely correlated with CIMT in both groups.
  
  
  CONCLUSIONS
  CIMT is associated with increased androgens in CAH adolescents and young adults, with loss of sex differences in CAH females with excess androgen exposure. Our findings highlight the importance of hormonal control for CVD prevention in CAH.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, Calif., USA.
authors.forename: Mimi S
authors.initials: MS
authors.lastname: Kim
authors.forename: Anh
authors.initials: A
authors.lastname: Dao-Tran
authors.forename: Elana
authors.initials: E
authors.lastname: Davidowitz
authors.forename: Teresa
authors.initials: T
authors.lastname: Tseng
authors.forename: Vicente
authors.initials: V
authors.lastname: Gilsanz
authors.forename: Anna
authors.initials: A
authors.lastname: Ryabets-Lienhard
authors.forename: Eugene
authors.initials: E
authors.lastname: Nguyen
authors.forename: Mitchell E
authors.initials: ME
authors.lastname: Geffner
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000503:physiopathology*; D000328:Adult; D000738:Androsterone / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D019326:17-alpha-Hydroxyprogesterone; D000738:Androsterone