The degree of external genitalia virilization in girls with 21-hydroxylase deficiency appears to be influenced by the CAG repeats in the androgen receptor gene
Abstract
Summary: Background Women with 21‐hydroxylase deficiency present much variability in external genitalia virilization, even among those with similar impairments of 21‐hydroxylase (21OH) activity. Objective To evaluate if the number of CAG (nCAG) repeats of the androgen receptor gene influences the degree of external genitalia virilization in women with CYP21A2 mutations, grouped according to impairment of 21OH activity. Patients The nCAG was determined in 106 congenital adrenal hyperplasia (CAH) patients and in 302 controls. The patients were divided, according to their CYP21A2 genotypes, into Groups A and B, which confer total and severe impairment of 21OH activity, respectively. Methods The inactivation pattern of the X‐chromosome was studied through genomic DNA digestion with Hpa II . The CAG repeat region was amplified by polymerase chain reaction (PCR) and analysed by GeneScan. Results The nCAG and the frequency of severe skewed X‐inactivation did not differ between normal women and patients. The nCAG median in genotype A was 20·7 (IQR 2·3) for Prader I + II, 22·5 (3·6) for Prader III and 21 (2·9) for Prader IV + V ( P < 0·05 for Prader III and Prader IV + V). The nCAG median in genotype B was 21·3 (1·1) for Prader I + II, 20·5 (2·9) for Prader III and 22 (2·8) for Prader IV + V ( P > 0·05). A significant difference was found regarding the nCAG median in patients presenting Prader III from genotypes A and B. Conclusions We observed great variability in the degree of external genitalia virilization in both CYP21A2 genotypes, and we showed that the CAG repeats of the androgen receptor gene influences this phenotypic variability.
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Apart from CAH genes, other genes may modify steroid action, salt balance or androgen sensitivity and affect phenotype.
“Apart from CAH genes, other genes may modify steroid action, salt balance or androgen sensitivity and affect phenotype.136,137,138”
From Congenital adrenal hyperplasia (2017) · cites this paper as [138]
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Congenital adrenal hyperplasia
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Self-citationLinking the degree of virilization in females with congenital adrenal hyperplasia to genotype
Gurgov, S., Bernabé, K. J., Stites, J., Cunniff, C. M., Lin‐Su, K., Felsen, D., New, M. I., & Poppas, D. P. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13370 · Cited by 17 · see citing works
- Authors
- Rocha, R. O., Billerbeck, A. E. C., Pinto, E. M., Melo, K. F. S., Lin, C. J., Longui, C. A., Mendonca, B. B., & Bachega, T. A. S. S.
- Affiliations
- Universidade de São Paulo (BR)
- Corresponding author
- Bachega, Tânia A. S. S.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2007-07-30
- Volume
- 68
- Issue
- 2
- Pages
- 226-232
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2168058673
- Cited by
- 43
- References
- 46
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2021: 2 · 2020: 1 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 6 · 2013: 2 · 2012: 2
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Keywords
- 21-hydroxylase deficiency, congenital adrenal hyperplasia, androgen receptor gene, CAG repeat, phenotypic variability, X chromosome inactivation
- MeSH terms
- Adrenal Hyperplasia, Congenital, Female, Genotype, Humans, Male, Receptors, Androgen, Steroid 21-Hydroxylase, Virilism, Trinucleotide Repeats
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