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Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency

  • Christiaan F. Mooij , Antonius E. van Herwaarden , Fred C.G.J. Sweep , Nel Roeleveld , Chris L. de Korte , Livia Kapusta and Hedi L. Claahsen-van der Grinten EMAIL logo
Published/Copyright: August 8, 2017
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 30 Issue 9

Abstract

Background:

The aim of the study was to evaluate the cardiovascular and metabolic risk profile in pediatric patients with congenital adrenal hyperplasia (CAH).

Methods:

A cross-sectional study was performed in 27 CAH patients (8–16 years). Blood samples were taken to evaluate circulating cardiovascular risk (CVR) markers. Insulin resistance (IR) was evaluated by homeostatic model assessment (HOMA)-IR. Blood pressure (BP) was evaluated by office BP measurements and 24-h ambulatory BP measurements (24-h ABPM). Dual energy X-ray absorptiometry (DXA) scans were performed in patients >12 years.

Results:

Body mass index (BMI) standard deviation score (SDS) was elevated (0.67), with seven patients being overweight and four obese. DXA scans showed percentage body fat SDS of 1.59. Office BP levels were higher than reference values. Twenty-four hour ABPM showed systolic hypertension (n=5), while 11 patients had a non-dipping BP profile. HOMA-IR was >75th percentile in 12 patients.

Conclusions:

CAH patients develop an unfavorable CVR profile already in childhood with increased BMI, increased fat mass, elevated BP levels, a non-dipping BP profile and IR compared to population reference values.

Keywords: cardiovascular risk; congenital adrenal hyperplasia; hypertension; insulin resistance; obesity
Corresponding author: Hedi L. Claahsen-van der Grinten, MD, PhD, Division of Pediatric Endocrinology, Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, (804) PO Box 9101, 6500 HB, Nijmegen, The Netherlands, Phone: +31 24 3614430, Fax: +31 24 3614427

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This work was supported by ZonMW (AGIKO Grant to Christiaan F. Mooij) and Stichting Kindercardiologie Nijmegen (research grant to Christiaan F. Mooij).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-2-12
Accepted: 2017-7-20
Published Online: 2017-8-8
Published in Print: 2017-8-28

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Standard body mass index reference data of prepubescent diabetic Egyptian children
  4. Frequency and risk factors of depression in type 1 diabetes in a developing country
  5. Association of obesity and health related quality of life in Iranian children and adolescents: the Weight Disorders Survey of the CASPIAN-IV study
  6. Association between urinary phthalates and metabolic abnormalities in obese Thai children and adolescents
  7. A pilot study of the effect of human breast milk on urinary metabolome analysis in infants
  8. Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio?
  9. Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency
  10. Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency
  11. Influence of topical iodine-containing antiseptics used during delivery on recall rate of congenital hypothyroidism screening program
  12. Applying targeted next generation sequencing to dried blood spot specimens from suspicious cases identified by tandem mass spectrometry-based newborn screening
  13. Short Communication
  14. Initial patient choice of a growth hormone device improves child and adolescent adherence to and therapeutic effects of growth hormone replacement therapy
  15. Case Reports
  16. An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm
  17. Fetal goitrous hypothyroidism treated by intra-amniotic levothyroxine administration: case report and review of the literature
  18. Carotid intima media thickness in a girl with sitosterolemia carrying a homozygous mutation in the ABCG5 gene
  19. Sirolimus in the treatment of three infants with diffuse congenital hyperinsulinism
https://doi.org/10.1515/jpem-2017-0068
Keywords for this article
cardiovascular risk; congenital adrenal hyperplasia; hypertension; insulin resistance; obesity

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Standard body mass index reference data of prepubescent diabetic Egyptian children
  4. Frequency and risk factors of depression in type 1 diabetes in a developing country
  5. Association of obesity and health related quality of life in Iranian children and adolescents: the Weight Disorders Survey of the CASPIAN-IV study
  6. Association between urinary phthalates and metabolic abnormalities in obese Thai children and adolescents
  7. A pilot study of the effect of human breast milk on urinary metabolome analysis in infants
  8. Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio?
  9. Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency
  10. Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency
  11. Influence of topical iodine-containing antiseptics used during delivery on recall rate of congenital hypothyroidism screening program
  12. Applying targeted next generation sequencing to dried blood spot specimens from suspicious cases identified by tandem mass spectrometry-based newborn screening
  13. Short Communication
  14. Initial patient choice of a growth hormone device improves child and adolescent adherence to and therapeutic effects of growth hormone replacement therapy
  15. Case Reports
  16. An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm
  17. Fetal goitrous hypothyroidism treated by intra-amniotic levothyroxine administration: case report and review of the literature
  18. Carotid intima media thickness in a girl with sitosterolemia carrying a homozygous mutation in the ABCG5 gene
  19. Sirolimus in the treatment of three infants with diffuse congenital hyperinsulinism
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