The relationship of carotid intima-media thickness with anthropometric and metabolic parameters in patients with classic congenital adrenal hyperplasia

Background/aim We aimed to determine the presence of subclinical atherosclerosis using carotid intima-media thickness (CIMT) and biochemical parameters in children and adolescents with congenital adrenal hyperplasia (CAH). Materials and methods Thirty-four patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency on regular glucocorticoid treatment for ≥3 years and 31 healthy subjects were included in the study. The patients were divided into two groups according to the degree of control of the clinic, laboratory, and radiological parameters as a) “uncontrolled” [n= 22; with increased height velocity (HV) standard deviation score (SDS) (≥2 SDS), advanced bone age, serum 17-OH progesterone <2.0 and ≥10.0 ng/mL or androstenedione <0.3 and ≥ 3.0 ng/mL] or b) “controlled” [n= 12; with HV SDS < 2, bone age (BA)/ chronologic age (CA) ratio < 1.2, serum 17-OH progesterone between 2 and 10 ng/mL and androstenedione between 0.3 and 3.0 ng/mL]. Ultrasonographic examination of carotid artery was performed by the same radiologist using a B-mode ultrasound system. Results There was no significant difference between the CAH and control groups in terms of median (IQR) CIMT values [0.47 (0.05) mm and 0.47 (0.07) mm, respectively; p > 0.05]. When subgroup comparisons were done in terms of median (IQR) CIMT values, there was no significant difference among the controlled, uncontrolled, and healthy control groups [0.45 (0.03) mm, 0.47 (0.04) mm, 0.47 (0.07) mm, respectively; p> 0.05]. In addition, CIMT levels were similar according to sex and disease control status. Conclusion In this study, the CIMT values of CAH cases were similar to those of healthy subjects.

[1]  F. Darendeliler,et al.  New Features for Child Metrics: Further Growth References and Blood Pressure Calculations , 2020, Journal of clinical research in pediatric endocrinology.

[2]  B. Keevil Steroid Mass Spectrometry for the Diagnosis of PCOS , 2019, Medical sciences.

[3]  A. Abacı,et al.  Impaired systolic and diastolic left ventricular function in children and adolescents with congenital adrenal hyperplasia receiving corticosteroid therapy , 2019, Cardiology in the Young.

[4]  P. Concolino,et al.  Congenital Adrenal Hyperplasia (CAH) due to 21-Hydroxylase Deficiency: A Comprehensive Focus on 233 Pathogenic Variants of CYP21A2 Gene , 2018, Molecular Diagnosis & Therapy.

[5]  Section On Endocrinology,et al.  The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering , 2017, Pediatric Clinical Practice Guidelines & Policies.

[6]  E. Goodman,et al.  The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering , 2017, Pediatrics.

[7]  B. Özkan,et al.  Assessment of early atherosclerosis and left ventricular dysfunction in children with 21‐hydroxylase deficiency , 2017, Clinical endocrinology.

[8]  M. New,et al.  Steroid 21-hydroxylase deficiency in congenital adrenal hyperplasia , 2017, The Journal of Steroid Biochemistry and Molecular Biology.

[9]  M. Geffner,et al.  Carotid Intima-Media Thickness Is Associated with Increased Androgens in Adolescents and Young Adults with Classical Congenital Adrenal Hyperplasia , 2016, Hormone Research in Paediatrics.

[10]  D. Ozel,et al.  Obtaining accurate measurement of carotid intima-media thickness in children with classic congenital adrenal hyperplasia , 2016, European Journal of Pediatrics.

[11]  F. Baş,et al.  Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children , 2015, Journal of clinical research in pediatric endocrinology.

[12]  M. Atabek,et al.  Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Patients with Congenital Adrenal Hyperplasia: A Preliminary Report , 2015, Journal of clinical research in pediatric endocrinology.

[13]  A. Lenzi,et al.  Cardiovascular abnormalities and impaired exercise performance in adolescents with congenital adrenal hyperplasia. , 2015, The Journal of clinical endocrinology and metabolism.

[14]  Y. A. Ibrahim,et al.  Carotid intima media thickness and other cardiovascular risk factors in children with congenital adrenal hyperplasia , 2014, Journal of Endocrinological Investigation.

[15]  N. Mohammadifard,et al.  Body Mass Index, Waist-circumference and Cardiovascular Disease Risk Factors in Iranian Adults: Isfahan Healthy Heart Program , 2013, Journal of health, population, and nutrition.

[16]  N. Charfi,et al.  Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency , 2012, Indian journal of endocrinology and metabolism.

[17]  Mohamed Abid,et al.  Long-Term Outcome of Patients With Congenital Adrenal Hyperplasia Due to 21-hydroxylase Deficiency , 2012, The American journal of the medical sciences.

[18]  J. Couper,et al.  Adolescents with congenital adrenal hyperplasia because of 21‐hydroxylase deficiency have vascular dysfunction , 2012, Clinical endocrinology.

[19]  H. Falhammar,et al.  Cardiovascular risk, metabolic profile, and body composition in adult males with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. , 2011, European journal of endocrinology.

[20]  P. Home,et al.  Carotid intima-media thickness as a surrogate marker of cardiovascular disease in diabetes , 2011, Diabetes, metabolic syndrome and obesity : targets and therapy.

[21]  V. Montori,et al.  Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. , 2010, The Journal of clinical endocrinology and metabolism.

[22]  V. Montori,et al.  Clinical review: Adult height in patients with congenital adrenal hyperplasia: a systematic review and metaanalysis. , 2010, The Journal of clinical endocrinology and metabolism.

[23]  K. Lackner,et al.  Alterations in Lipid and Carbohydrate Metabolism in Patients with Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency , 2010, Hormone Research in Paediatrics.

[24]  L. Ravà,et al.  Blood Pressure and Left Ventricular Characteristics in Young Patients with Classical Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency , 2010, International journal of pediatric endocrinology.

[25]  C. Tack,et al.  Unfavourable trends in cardiovascular and metabolic risk in paediatric and adult patients with congenital adrenal hyperplasia? , 2009, Clinical endocrinology.

[26]  C. Scaroni,et al.  Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. , 2007, The Journal of clinical endocrinology and metabolism.

[27]  J. Dötsch,et al.  Altered 24-hour blood pressure profiles in children and adolescents with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. , 2006, The Journal of clinical endocrinology and metabolism.

[28]  G. Chrousos,et al.  Metabolic Syndrome Manifestations in Classic Congenital Adrenal Hyperplasia , 2006, Annals of the New York Academy of Sciences.

[29]  E. Wiltshire,et al.  Vascular endothelial and smooth muscle function relates to body mass index and glucose in obese and nonobese children. , 2006, The Journal of clinical endocrinology and metabolism.

[30]  H. Dörr,et al.  Obesity Among Children and Adolescents With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency , 2006, Pediatrics.

[31]  S. Kanumakala,et al.  24-hour Ambulatory Blood Pressure Profile in Patients with Congenital Adrenal Hyperplasia - A Preliminary Report , 2004, Journal of pediatric endocrinology & metabolism : JPEM.

[32]  T. Lehtimäki,et al.  Endothelial Dysfunction and Increased Arterial Intima-Media Thickness in Children With Type 1 Diabetes , 2004, Circulation.

[33]  M. Dattani,et al.  Blood pressure in children and adolescents with congenital adrenal hyperplasia (21‐hydroxylase deficiency): a preliminary report , 2003, Clinical endocrinology.

[34]  A. Kafatos,et al.  Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index , 2000, International Journal of Obesity.

[35]  A. Arango,et al.  Lipid profile in congenital adrenal hyperplasia. , 2000, Metabolism: clinical and experimental.

[36]  Arno W. Hoes,et al.  Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. , 1997, Circulation.

[37]  Kotb Abbass Metwalley,et al.  Left ventricular dysfunction and subclinical atherosclerosis in children with classic congenital adrenal hyperplasia: a single-center study from upper Egypt , 2015, European Journal of Pediatrics.

[38]  H. Falhammar,et al.  Metabolic profile and body composition in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. , 2007, The Journal of clinical endocrinology and metabolism.

[39]  H. Willgerodt,et al.  Blood Pressure in Patients with Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency , 2006, Journal of pediatric endocrinology & metabolism : JPEM.