Objective: There is controversy regarding cognitive function in patients with congenital adrenal hyperplasia (CAH). This study is aimed at the assessment of cognitive functions in children with CAH, and their relation to hydrocortisone (HC) therapy and testosterone levels. Subjects and methods: Thirty children with CAH due to 21 hydroxylase deficiency were compared with twenty age-and sexmatched healthy controls. HC daily and cumulative doses were calculated, the socioeconomic standard was assessed, and free testosterone was measured. Cognitive function assessment was performed using the Wechsler Intelligence Scale-Revised for Children and Adults (WISC), the Benton Visual Retention Test, and the Wisconsin Card Sorting Test (WCST). Results: The mean age (SD) of patients was 10.22 (3.17) years [11 males (36.7%), 19 females (63.3%)]. Mean (SD) HC dose was 15.78 (4.36) mg/ m 2 /day. Mean (SD) cumulative HC dose 44,689. 9 (26,892.02) mg. Patients had significantly lower scores in all domains of the WISC test, performed significantly worse in some components of the Benton Visual Retention Test, as well as in the Wisconsin Card Sorting Test. There was no significant difference in cognitive performance when patients were subdivided according to daily HC dose (< 10, 10-15, > 15 mg/m 2 /day). A positive correlation existed between cumulative HC dose and worse results of the Benton test. No correlation existed between free testosterone and any of the three tests. Conclusion: Patients with CAH are at risk of some cognitive impairment. Hydrocortisone therapy may be implicated. This study highlights the need to assess cognitive functions in CAH.
Aim: We aimed to assess antioxidant status in Egyptian children with obesity and investigate the mutual relationship between oxidative stress markers, body composition, and metabolic pattern.
Methods:This cross-sectional study included 52 obese and 20 healthy-weight children. Subjects underwent through clinical assessment. Serum lipid profile, fasting glucose, and serum insulin were measured in plasma. A range of antioxidant activities was tested. Steady state beta cell function (%B), insulin sensitivity (%S), and insulin resistance (IR) were calculated.Results: Children with obesity had high prevalence of family history of obesity, hypertension and type 2 diabetes and 18 of them had hypertension. Sixteen (30.7%) children with obesity had high level (90 th percentiles) of lowdensity lipoprotein (LDL-C) and triglycerides and 14 (24.9%) had low level (10 th percentiles) of high-density lipoprotein (HDL-C). Plasma malondialdehyde (MDA), glutathione-S-transferase (GST) were significantly higher, whereas catalase, total antioxidant capacity (TAC), and vitamin E were significantly lower in children with obesity. Both MDA and GST correlated positively with anthropometric measures, triglycerides, fasting insulin, and HOMA-IR. Both catalase and TAC correlated negatively with anthropometric measures, and cholesterol. Furthermore, catalase correlated negatively with diastolic blood pressure, triglycerides, LDL, fasting insulin, and HOMA-IR, but positively with age.
Conclusion:There is a substantial burden of oxidative stress represented by the high level of oxidants (MDA, GST) and low level of antioxidants (catalase, TAC) in children with obesity necessitating improvement in the management of childhood obesity.
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