Obesity in children with congenital adrenal hyperplasia in the Minnesota cohort: importance of adjusting body mass index for height‐age

Sarafoglou, Kyriakie; Forlenza, Gregory P.; Addo, O Yaw; Kyllo, Jennifer; Lteif, Aida; Hindmarsh, Peter C.; Petryk, Anna; Gonzalez-Bolanos, Maria Teresa; Miller, Bradley S.; Thomas, William

doi:10.1111/cen.13313

Cited by 29 publications

(27 citation statements)

References 34 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is essential to carefully adjust HC dosing in CAH children, especially during early childhood, to prevent increased weight gain and an early adiposity rebound. 18 The adiposity rebound is defined as the second increase in BMI that happens in preschoolers until the age of 7. An early age at adiposity rebound is a risk factor for adult obesity.…”

Section: Discussionmentioning

confidence: 99%

Growth characteristics in children with congenital adrenal hyperplasia

Alzanbagi

Milyani

Al-Agha

2018

SMJ

View full text Add to dashboard Cite

Objectives:To evaluate the growth parameters in congenital adrenal hyperplasia patients in Jeddah, Saudi Arabia.Methods:This is a descriptive retrospective study over the period of 5 years. Data analysis was using Statistical Package for Social Science. The study included 90 participants in which 61 were girls and 29 were boys aged 0 to 18 years . They were evaluated in Pediatric Endocrinology Clinic at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, between January 2012 and January 2017.Results:A total of 90 subjects, of which 67.8% were females and 32.2% were males. Subjects who were underweight constituted 19.1% of the population, while those who were obese were estimated up to 17.6% of the population. Of the children, 25.7% were suffering from short stature and 74.3% had normal height. Approximately 11.8% of the children who suffered from short stature also suffered from hypothyroidism. Mid-parental height of those who suffered from short stature is 159.8 cm.Conclusion:This study showed a significant effect of congenital adrenal hyperplasia on both height, weight, and body mass index. Risk factors includes glucocorticoids dosage, compliance to treatment, and regular follow up. Personalized treatment approach should be followed with all patients diagnosed with congenital adrenal hyperplasia as well as close monitoring and targeted therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Growth characteristics in children with congenital adrenal hyperplasia

Alzanbagi

Milyani

Al-Agha

2018

SMJ

View full text Add to dashboard Cite

show abstract

“…Treatment with excessively high dose of glucocorticoids must be avoided as it may lead to the development of diabetes and obesity, insulin resistance, and osteoporosis (1, 2, 20, 21). Glucocorticoid-induced hyperglycemia depends on the total glucocorticoid dose and duration of therapy and may occur also in <1 month (22).…”

Section: Discussionmentioning

confidence: 99%

The High Prevalence of Testicular Adrenal Rest Tumors in Adult Men With Congenital Adrenal Hyperplasia Is Correlated With ACTH Levels

Mazzilli¹,

Stigliano²,

Delfino³

et al. 2019

Front. Endocrinol.

View full text Add to dashboard Cite

Introduction: The aims of this study were to determine the prevalence of testicular-adrenal rest tumors (T-ARTs) in patients with congenital adrenal hyperplasia (CAH) and to evaluate the related ultrasound (US) features, hormonal profiles, and semen parameters. Therefore, we attempted to understand the potential impact of adrenocorticotropic hormone (ACTH) on the persistence or disappearance of T-ART. Methods: We conducted a longitudinal cohort study including patients with CAH who were undergoing treatment with cortisone and, when indicated, fludrocortisone replacement therapy. We performed andrological examinations, US of the testis, hormone profiling, and semen analysis. Results: Of the 25 patients (mean ± SD age, 32.2 ± 7.5 years), T-ARTs were detected by US in 14 (56.0%) patients. The mean ± SD diameter of the lesions was 13.2 ± 6.8 mm. Among 3 (21.4%) patients, the lesions were observed in one testis, whereas both testes were affected in the remaining 11 (78.6%) patients. The lesions were hypoechoic in 12 (85.7%) patients and hyperechoic in 2 (14.3%). Plasma ACTH and 17-hydroxyprogesterone (17-OHP) levels were significantly higher in patients with T-ART than in patients without lesions (319.4 ± 307.0 pg/ml and 12.4 ± 2.7 ng/ml vs. 33.5 ± 10.7 pg/ml and 8.2 ± 1.8 ng/ml, respectively; p < 0.01). The mean values of sperm concentration and motility were significantly lower in patients with T-ART than in patients without lesions (12.1 ± 12.4 × 10 6 cells/ml and 18.4 ± 11.1% vs. 41.5 ± 23.2 × 10 6 cells/ml and 30.8 ± 15.4%, respectively; p < 0.05). Logistic regression analysis showed ACTH level as a significant predictor of T-ART ( p < 0.05). In patients with T-ART, the dose of hydrocortisone was increased by ~25–30%, while the fludrocortisone treatment remained unchanged. After 6 months of steroid treatment, patients underwent US and hormonal evaluation. Disappearance and a reduction in T-ART were observed in 6 (42.9%) and 5 (35.7%) patients, respectively; a reduction in ACTH levels (from 319.4 ± 307.0 to 48.1 ± 5.1 pg/ml; p < 0.01) was reported. A significant correlation between ACTH level reduction and T-ART diameter reduction was observed ( p < 0.5; r = 0.55). Conclusions: T-ARTs were detected in 56% of patients with CAH and were associated with impaired semen parameters. However, these lesions are potentially reversible, as demonstrated by the disappearance/reduction after adjustment of cortisone therapy and by the reduction in plasma ACTH level. Our study supports the importance of periodic US evaluation and maintenance of plasma ACTH levels within the normal range in men with CAH.

show abstract

“…The major cardiovascular risk factor in CAH seems to be overweight and obesity [20]. Obesity was identified already a major problem in pediatric cohorts [25,26]. In adult cohorts even more than half of the female patients were found to be obese [20].…”

Section: Cardiovascular Morbiditiesmentioning

confidence: 99%

Review of Health Problems in Adult Patients with Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

Reisch

2019

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

The introduction of newborn screening programmes in most Western countries for classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) enables timely introduction of life-saving glucocorticoid replacement in affected babies. Early diagnosis and optimised pediatric care not only successfully led to survival but also allow that almost all patients reach adulthood. Cohort studies in adults, however, provided evidence for significant health problems and co-morbidities of adult patients such as life-threatening adrenal crises, cardiovascular and metabolic health problems, fertility problems, benign endocrine tumours, and osteopenia and osteoporosis. This review summarises the current state of knowledge aiming to emphasize the neccessity of primary and secondary prevention of additional long-term health issues as a major task of health professionals in the care of CAH.

show abstract

Obesity in children with congenital adrenal hyperplasia in the Minnesota cohort: importance of adjusting body mass index for height‐age

Cited by 29 publications

References 34 publications

Growth characteristics in children with congenital adrenal hyperplasia

Growth characteristics in children with congenital adrenal hyperplasia

The High Prevalence of Testicular Adrenal Rest Tumors in Adult Men With Congenital Adrenal Hyperplasia Is Correlated With ACTH Levels

Review of Health Problems in Adult Patients with Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

Contact Info

Product

Resources

About