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Year : 2012  |  Volume : 16  |  Issue : 6  |  Page : 939-946

Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

1 Department of Endocrinology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
2 Department of Radiology, Hedi Chaker Hospital, 3029 Sfax, Tunisia
3 Department of Endocrinology and Internal Medicine, Tahar Sfar Hospital, 5111 Mahdia, Tunisia
4 Department of Pediatric, Tahar Sfar Hospital, 5111 Mahdia, Tunisia
5 Department of Pediatric, Hedi Chaker Hospital, 3029 Sfax, Tunisia

Correspondence Address:
Mahdi Kamoun
Department of Endocrinology, HediChaker Hospital, MagidaBoulila Avenue, 3029 Sfax
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2230-8210.102995

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Background: In congenital adrenal hyperplasia (CAH), long-term glucocorticoid treatment coupled with increased androgens may lead to undesirable metabolic effects. The aim of our report was to determine the prevalence of metabolic abnormalities and cardiovascular risk factors in a population of adult patients with CAH due to 21 hydroxylase deficiency. Materials and Methods: Twenty-six patients (11 males and 15 females, mean age ± SD=27.4±8.2 years) were recruited. Anthropometry, body composition, metabolic parameters and cardiovascular risk factors were studied. Results: Obesity (overweight included) was noted in 16 patients (61.5%), with android distribution in all cases. Bioelectrical impedance showed increased body fat mass in 12 patients (46.1%). Lipid profile alterations and carbohydrate metabolism disorders were detected in seven (26.9%) and five (19.2%) patients respectively. Moderate hepatic cytolysis, associated with hepatic steatosis, was found in one patient. Seven patients (27%) had insulin resistance. Ambulatory blood pressure monitoring showed abnormalities in six patients (23%). Increased carotid intima media thickness was found in 14 patients (53.8%). Conclusion: Adult CAH patients tend to have altered metabolic parameters and a higher prevalence of cardiovascular risk factors. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.

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