Espinosa RTM, Hernández MJA, Domínguez AE

Language: Spanish
References: 29
Page: 1-14
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ABSTRACT

Introduction: Some disagreement exists concerning the increase in abdominal adiposity in patients with congenital adrenal hyperplasia and the influence of clinical, hormonal and dose-related factors and the time of steroid treatment use.
Objective: To identify the presence of abdominal obesity and its relationship with the dose and time of steroid treatment, as well as with the levels of circulating androgens, and describe the lipid profile of these patients.
Methods: Cross-sectional and descriptive study that included all the children and adolescents with 21-hydroxylase-deficient congenital adrenal hyperplasia and who received steroid replacement treatment, treated at the pediatric endocrinology department of the National Institute of Endocrinology, in the period 2000-2015. Clinical, biochemical and hormonal variables were studied. For the qualitative variables, absolute frequencies and percentages; mean and standard deviations were calculated for the quantitative variables. Associations were evaluated using the Spearman correlation coefficient. The chi-square test was used to evaluate the statistical significance of the possible association, considered when p < 0.05.
Results: Twenty-nine patients were studied: 24 (82.8 %) with female social sex, an average age of 10.9 ± 6.27 years, age of diagnosis at 1.9 ± 2.7 years, and age of treatment beginning at 2.03 ± 2.7 years. The classical forms predominated in 23 patients (79.3 %): 11 salt losers (47.8 %) and 12 simple virializing forms; only six corresponded to non-classical forms (20.7 %). In the three groups, increased abdominal adiposity was found, according to abdomen/height index (0.52 vs. 0.51 vs. 0.51). The use of higher doses of steroids was correlated positively with greater circumference of waist (p < 0.05) and abdomen (p < 0.01). In 13 (44.8 %) patients, abdominal obesity was found, while the lipid profile showed normal values in all the cases studied.
Conclusions: Abdominal obesity is a frequent sign in patients with congenital adrenal hyperplasia. It is necessary to monitor accurately the doses of steroids used, establish more comprehensive follow-up strategies, and encourage healthy lifestyles, which will result in fewer long-term cardiometabolic consequences.

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