Metabolic evaluation of young women with congenital adrenal hyperplasia

Schnaider-Rezek, Gabrielle Sormanti; Lemos-Marini, Sofia Helena Valente de; Baptista, Mónica; Guerra‐Júnior, Gil; Morcillo, André Moreno; Mello, Maricilda Palandi de; Oliveira, Laurione Cândido de; D’Souza-Li, Lília

doi:10.1590/s0004-27302011000800021

Cited by 6 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several groups have reported insulin resistance as a common feature of both classic 21hydroxylase deficiency and classic 11-hydroxylase activity [5][6][7][8][9][10][11][12][13][14]. Importantly, in most of these studies, the insulin resistance was independent of the corticosteroid dosage, suggesting that it is intrinsic to CAH, rather than a result of exogenous corticosteroid.…”

Section: Recognition Of Insulin Resistance In Cahmentioning

confidence: 99%

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Sacerdote¹,

Bahtiyar²

2015

Contemporary Gynecologic Practice

View full text Add to dashboard Cite

Among the most common causes of female infertility, anovulation, menstrual irregularity, hirsutism, acne, and alopecia are congenital adrenal hyperplasia (CAH) and polycystic ovarian syndrome (PCOS). These two conditions resemble one another quite a bit, especially the nonclassic forms of CAH (NCAH). Another common cause of such problems is hyperprolactinemia, which results in increased androgen synthesis by both the ovaries and the adrenal cortex, while suppressing gonadotrophin-releasing hormone, gonadotrophin, and estrogen synthesis. Hyperprolactinemia, in turn, may be caused by primary hypothyroidism, prolactinomas, stalk effects of other pituitary and hypothalamic neoplasia, as well as a host of prescription and recreational drugs; it may also be idiopathic. Other, less frequently encountered causes of these problems include Cushing's syndrome and virilizing tumors (ovarian, adrenal, or ectopic). A growing worldwide problem in this sphere is androgen doping to improve athletic performance. Additional causes of menstrual irregularity include uterine leiomyomata, puberty, perimenopause, chronic illnesses eg. poorly controlled diabetes mellitus and sickle cell disease, elite athletics and dancing, eating disorders, endometriosis, and Asherman's syndrome. Infertility may also be caused by stress, tubal factors, Asherman's syndrome, immune response to spermatozoa, luteal phase inadequacy, and male factors. In this chapter we shall focus on 3 novel concepts: • The treatment of the congenital adrenal hyperplasias and the acquired/unmasked adrenal hyperplasias by interventions which reduce insulin resistance.

show abstract

Section: Recognition Of Insulin Resistance In Cahmentioning

confidence: 99%

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Sacerdote¹,

Bahtiyar²

2015

Contemporary Gynecologic Practice

View full text Add to dashboard Cite

show abstract

“…Insulin resistance may also develop through the metabolic effects of androgens. 7,13,14 The precise mechanism for cardiovascular risk is still unclear.…”

Section: Clinical Presentation Of Hyperandrogenismmentioning

confidence: 99%

17-Hydroxyprogesterone in children, adolescents and adults

Honour

2014

Ann Clin Biochem

View full text Add to dashboard Cite

17-Hydroxyprogesterone (17-OHP) is an intermediate steroid in the adrenal biosynthetic pathway from cholesterol to cortisol and is the substrate for steroid 21-hydroxylase. An inherited deficiency of 21-hydroxylase leads to greatly increased serum concentrations of 17-OHP, while the absence of cortisol synthesis causes an increase in adrenocorticotrophic hormone. The classical congenital adrenal hyperplasia (CAH) presents usually with virilisation of a girl at birth. Affected boys and girls can have renal salt loss within a few days if aldosterone production is also compromised. Diagnosis can be delayed in boys. A non-classical form of congenital adrenal hyperplasia (NC-CAH) presents later in life usually with androgen excess. Moderately raised or normal 17-OHP concentrations can be seen basally but, if normal and clinical suspicion is high, an ACTH stimulation test will show 17-OHP concentrations (typically >30 nmol/L) above the normal response. NC-CAH is more likely to be detected clinically in females and may be asymptomatic particularly in males until families are investigated. The prevalence of NC-CAH in women with androgen excess can be up to 9% according to ethnic background and genotype. Mutations in the 21-hydroxylase genes in NC-CAH can be found that have less deleterious effects on enzyme activity. Other less-common defects in enzymes of cortisol synthesis can be associated with moderately elevated 17-OHP. Precocious puberty, acne, hirsutism and subfertility are the commonest features of hyperandrogenism. 17-OHP is a diagnostic marker for CAH but opinions differ on the role of 17OHP or androstenedione in monitoring treatment with renin in the salt losing form. This review considers the utility of 17-OHP measurements in children, adolescents and adults.

show abstract

“…Adults patients with classical CAH have a higher frequency of obesity, visceral obesity, hyperinsulinism, insulin resistance and hyperandrogenism compared with normal individuals (3).…”

Section: Introductionmentioning

confidence: 94%

“…There are no adequate studies investigating the prevalence of metabolic syndrome parameters in children and adolescents with CAH. Moreover, different definitions (modified NCEP ATP III, modified Weiss, modified IDF definition) were used in evaluation of MS in the limited number of studies and different results were obtained (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Konjenital adrenal hiperplazi tanılı çocuk ve adolesanlarda farklı metabolik sendrom tanı kriterlerine göre metabolik sendrom sıklığı: tek merkez çalışması

Babalıoğlu

Keskin

Aycan

2018

Turkish Journal of Clinics and Laboratory

View full text Add to dashboard Cite

Aim: The aim of this study was to investigate the prevalence of metabolic syndrome according to different metabolic syndrome definitions in children and adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Material and Methods: A total number of 45 patients (31 patients with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency and 14 patients with non-classical congenital adrenal hyperplasia) were enrolled to the study. The anthropometric, clinical, hormonal findings and the dose of hydrocortisone were analyzed starting from the initial day of diagnosis until the beginning of our study and the metabolic controls (good-bad) were evaluated in the follow-up period. At the last visit, systemic and anthropometric examinations (involving measures of height, weight, waist circumference and blood pressure) was performed by the same physician. Serum lipid levels were examined and oral glucose tolerance tests were performed. Metabolic syndrome prevalence in our patients was calculated with respect to the modified criteria of WHO, IDF and NCEP ATP III. Results: Metabolic syndrome was diagnosed in only 1 (2.2%) of the 45 patients in the study according to modified WHO definition, 8 patients (17.8%) received a diagnosis of metabolic syndrome according to NCEP ATP III definition. Metabolic syndrome was diagnosed in 1 (3.3%) of 30 patients above 10 years of age according to IDF definition and 20% of patients aged 6-10 years were considered to be risky for development of metabolic syndrome. Conclusion: It was found that the prevalence of metabolic syndrome was highest when NCEP ATP III definition was used.

show abstract

Metabolic evaluation of young women with congenital adrenal hyperplasia

Cited by 6 publications

References 29 publications

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

17-Hydroxyprogesterone in children, adolescents and adults

Konjenital adrenal hiperplazi tanılı çocuk ve adolesanlarda farklı metabolik sendrom tanı kriterlerine göre metabolik sendrom sıklığı: tek merkez çalışması

Contact Info

Product

Resources

About