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Cited by 27Sexual Differentiation and DisordersAdrenal Hormones and DisordersOvarian function and disorders

Long-term cardio-metabolic outcomes in patients with classical congenital adrenal hyperplasia: is the risk real?

Gomes, Larissa G., Mendonca, Berenice B., Bachega, Tânia A.S.S.·2020·Current Opinion in Endocrinology, Diabetes & Obesity
DOI 10.1097/med.0000000000000545
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Abstract

Purpose of review: Data on the long-term cardio-metabolic outcomes classical congenital adrenal hyperplasia (CAH) patients have been published with controversial results. Conventional treatment recommends hydrocortisone during childhood; and short and/or long-acting glucocorticoid during adulthood, associated or not with mineralocorticoid, in an attempt to simulate normal cortisol secretion and to normalize androgen excess. However, the balance between glucocorticoid over or undertreatment is very challenging, and patients frequently oscillate between hypercortisolism or hyperandrogenism. Considering these data, we reviewed the frequency of metabolic syndrome components and other cardiovascular risk factors in CAH. Recent findings: Several studies reported increased prevalence obesity, abnormal body composition, increased homeostasis model assessment of insulin resistance and blood pressure levels in CAH patients. However, the evidence quality is still low, because most studies used different glucocorticoid regimes and had heterogeneous goals for hormonal control. Summary: Despite the above-mentioned scenario of increased frequency of some cardiovascular surrogate markers in patients, most cohorts comprised young adults, and it is not known if patients will present high frequency of cardiovascular disease in the future. Prospective randomized studies comparing different glucocorticoid regimens should establish the real role of glucocorticoid and androgens on metabolic/cardiovascular profile.

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Crossref · 10.1097/med.0000000000000545

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  • In adolescent and adult CAH patients, normal left ventricular morphology has been reported, but mild diastolic dysfunction and impaired exercise performance were shown.

    “In adolescent and adult CAH patients, normal left ventricular morphology has been reported (677,684), but mild diastolic dysfunction and impaired exercise performance were shown.”

    From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [684]

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Authors
Gomes, L. G., Mendonca, B. B., & Bachega, T. A. S. S.
Affiliations
Universidade de São Paulo (BR)
Corresponding author
Bachega, Tânia A.S.S.
ORCID
Venue
Current Opinion in Endocrinology, Diabetes & Obesity
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-06
Volume
27
Issue
3
Pages
155-161
ISSN
  • 1752-296X (ISSN-L)
  • 1752-2978
DOI
10.1097/med.0000000000000545
OpenAlex
W3016832697
Cited by
27
References
12
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 12 · 2021: 5
FWCI
0.53
Type
journal article
Language
en
Open access
closed
Locations
  • Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Keywords
classical congenital adrenal hyperplasia, cardiometabolic outcomes, metabolic syndrome, obesity, insulin resistance, blood pressure, glucocorticoid therapy, cortisol, mineralocorticoid therapy, cardiovascular risk factors, hypercortisolism, hyperandrogenism, young adults
MeSH terms
Adrenal Hyperplasia, Congenital, Adult, Cardiovascular Diseases, Child, Humans, Prognosis, Risk Factors, Time Factors, Prevalence, Disease Progression, Metabolic Syndrome, Young Adult

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