title: Cardio-metabolic risk factors in youth with classical 21-hydroxylase deficiency.
abstract: Patients with congenital adrenal hyperplasia (CAH) appear to have adverse cardiovascular risk profile and other long-term health problems in adult life, but there are limited data in young CAH patients. We aim to evaluate the cardio-metabolic risk factors in adolescents and young adults with classical 21-hydroxylase deficiency (21-OHD). We performed a cross-sectional study of 21 patients (17 females) with classic CAH detected clinically and not through newborn screening, aged 15.2 ± 5.8 years, and 21 healthy matched controls. Anthropometric, biochemical, inflammatory markers, and body composition using dual-energy X-ray absorptiometry were measured. Obesity was observed in 33% of the CAH patients. The waist/hip ratio and waist/height ratio were significantly higher in CAH patients. Five out of 21 patients (24%) had elevated blood pressure. Silent diabetes was diagnosed in one patient (4.8%), but none in the control group. Serum leptin and interleukin-6 levels were not different between groups, but hs-CRP levels tended to be higher in CAH patients. Other metabolic profiles and body composition were similar in CAH and controls.
  
  
  CONCLUSIONS
  Adolescents and young adults with CAH appear to have an increased risk of obesity and cardio-metabolic risk factors. Close monitoring, early identification, and secondary prevention should be implemented during pediatric care to improve the long-term health outcomes in CAH patients. What is Known: • Lifelong glucocorticoid (GC) replacement is the main treatment modality in patients with congenital adrenal hyperplasia which predispose to an adverse metabolic profile. • Adult CAH patients have adverse cardiovascular risk profile and other long-term health problems. What is New: • Adolescents and young adults with CAH appear to have an increased risk of obesity and cardio-metabolic risk factors.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
authors.forename: Kansuda
authors.initials: K
authors.lastname: Ariyawatkul
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
authors.forename: Supatporn
authors.initials: S
authors.lastname: Tepmongkol
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
authors.forename: Suphab
authors.initials: S
authors.lastname: Aroonparkmongkol
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. Taninee.P@chula.ac.th.
authors.forename: Taninee
authors.initials: T
authors.lastname: Sahakitrungruang
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000378:metabolism; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D020738:Leptin
keywords: Adolescent; Body composition; Cardiovascular risk factors; Congenital adrenal hyperplasia; Metabolic syndrome