Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency
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CONTEXT: In congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, a tendency for obesity, high insulin, and high 24-h blood pressure levels has been reported in children and adolescents. Increased intima-media thickness (IMT) is considered a measure of subclinical atherosclerosis and a predictor of myocardial infarction and stroke. OBJECTIVE: The objective of the study was to evaluate glucose metabolism, lipid profile, IMT of the abdominal aorta, right and left common carotids, carotid bulbs, and common femoral arteries in adult CAH patients. SUBJECTS: Nineteen (10 females, nine males; 28 +/- 3.5 yr) patients (12 salt wasting and seven simple virilizing) and 19 (10 females, nine males) healthy subjects matched for anthropometric parameters (age, sex, body mass index, smoking habit, waist to hip ratio, and blood pressure). METHODS: Glucose metabolism was studied using the oral glucose tolerance test and the homeostasis model assessment-insulin resistance. The echo-Doppler was used for arterial ultrasound. 17-Hydroxyprogesterone, androstenedione, testosterone, ACTH, plasma renin activity, total and high-density lipoprotein cholesterol, and triglycerides were measured. RESULTS: CAH patients had significantly higher fasting plasma insulin (11.6 +/- 6.20 microU/ml vs 5.18 +/- 2.4 microU/ml; P < 0.0001) and homeostasis model assessment-insulin resistance than controls (2.46 +/- 1.92 vs 1.12 +/- 0.58; P = 0.0033). IMT of the studied arteries was higher in CAH patients than controls. There was no correlation between IMT and cumulative glucocorticoid doses and androgen levels. CONCLUSION: A reduced insulin sensitivity and increased IMT were demonstrated in adults with CAH, who consequently need a follow-up for cardiovascular risk.
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There are minimal data on the prevalence of hypertension in adults with CAH, with inconsistent results in individual studies conducted in different locales.
“There are minimal data on the prevalence of hypertension in adults with CAH (679,680), with inconsistent results in individual studies conducted in different locales (626,671,681).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [680]
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- Authors
- Sartorato, P., Zulian, E., Benedini, S., Mariniello, B., Schiavi, F., Bilora, F., Pozzan, G., Greggio, N., Pagnan, A., Mantero, F., & Scaroni, C.
- Affiliations
- University of Padua (IT)
- Corresponding author
- Scaroni, C.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2007-03-01
- Volume
- 92
- Issue
- 3
- Pages
- 1015-1018
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2030280115
- Cited by
- 132
- References
- 22
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 9 · 2017: 6 · 2016: 10 · 2015: 9 · 2014: 9 · 2013: 9 · 2012: 6
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Zenodo (CERN European Organization for Nuclear Research) (other-oa)
- Funders
- Università degli Studi di Padova
- 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
- congenital adrenal hyperplasia, 21-hydroxylase deficiency, intima-media thickness, subclinical atherosclerosis, cardiovascular risk factors, insulin resistance, insulin, carotid artery, femoral artery, abdominal aorta, carotid bulb, glucose metabolism, lipid profile, glucocorticoid dose, androgens, salt wasting, adults
- MeSH terms
- Adrenal Hyperplasia, Congenital, Adult, Aorta, Abdominal, Blood Glucose, Cardiovascular Diseases, Female, Femoral Artery, Glucose Tolerance Test, Hormones, Humans, Insulin, Insulin Resistance, Male, Risk Factors, Ultrasonography, Case-Control Studies, Carotid Artery, Common, Tunica Intima
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