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

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Title:	Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency
Author(s):	Mooij, C.F.; Herwaarden, A.E. van ; Sweep, C.G.J. ; Roeleveld, N. ; Korte, C.L. de ; Kapusta, L. ; Claahsen-van der Grinten, H.L.
Publication year:	2017
Source:	Journal of Pediatric Endocrinology & Metabolism, vol. 30, iss. 9, (2017), pp. 957-966
ISSN:	0334-018X
DOI:	https://doi.org/10.1515/jpem-2017-0068
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : https://hdl.handle.net/2066/177312
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Subject:	Radboudumc 10: Reconstructive and regenerative medicine RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health Sciences Radboudumc 4: lnfectious Diseases and Global Health RIMLS: Radboud Institute for Molecular Life Sciences
Organization:	Paediatrics Paediatrics - OUD tm 2017 Laboratory Medicine Health Evidence Radiology & Nuclear Medicine
Journal title:	Journal of Pediatric Endocrinology & Metabolism
Volume:	vol. 30
Issue:	iss. 9
Page start:	p. 957
Page end:	p. 966
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.