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Cited by 46Sexual Differentiation and DisordersAdrenal Hormones and DisordersOvarian function and disorders

Determining clinical and biological indicators for health outcomes in adult patients with childhood onset of congenital adrenal hyperplasia

Bachelot, Anne, Golmard, Jean Louis, Dulon, Jérôme, Dahmoune, Nora, Leban, Monique, Bouvattier, Claire, Cabrol, Sylvie, Leger, Juliane +2 more·2015·European Journal of Endocrinology
DOI 10.1530/eje-14-0978
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Abstract

Aim: Adverse outcomes in adult congenital adrenal hyperplasia (CAH) patients are frequent. The determinants of them have not yet been established. Objective: To establish the prevalence of adverse outcomes and to find determining factors for each of them. Design, patients, and methods: Cross-sectional monocentric study of 104 patients with childhood onset of CAH (71 women, 33 men). Analysis established first the determinants of clinical, hormonal, genetic variables and second a composite criterion for some of the outcomes and determinants. Results: BMI was above 25 kg/m 2 in 44% of the cohort, adrenal hyperplasia and/or nodules were present in 45% of the patients, and irregular menstrual cycles and hyperandrogenism were found in 50 and 35% of the women respectively. In univariate analysis, the determinants of these outcomes were all linked to disease control, especially 17-hydroxyprogesterone (17OHP) and androstenedione concentrations. Low weight was a determinant of abnormal bone mineral density (BMD) (60% of the cohort). Multivariate analysis confirmed these data. A classic form (CF) of CAH was a determinant of testicular adrenal rest tumors (TARTs) (36% of the men). Total cumulative glucocorticoid dose was a determinant of BMI and TART, whereas fludrocortisone dose was a determinant of TART (P=0.03). In men, the composite criterion was associated with androstenedione concentration and CF. In women, the composite criterion was associated with total testosterone concentration. Conclusion: The present study confirms the high prevalence of adverse outcomes in CAH patients. These are, most often, related to disease control. The impaired health status of adults with CAH could therefore be improved through the modification of treatment.

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Crossref · 10.1530/eje-14-0978

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  • Adjustments in glucocorticoid (and fludrocortisone) dose are usually necessary during pregnancy in women with CAH, especially in the third trimester.

    “Adjustments in glucocorticoid (and fludrocortisone) dose are usually necessary, especially in the third trimester (134), similar to pregnancies in women with primary adrenal insufficiency (668,669).”

    From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [669]

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Authors
Bachelot, A., Golmard, J. L., Dulon, J., Dahmoune, N., Leban, M., Bouvattier, C., Cabrol, S., Leger, J., Polak, M., & Touraine, P.
Affiliations
  • Hôpital Necker-Enfants Malades (FR)
  • Université Paris-Sud (FR)
Corresponding author
Touraine, Philippe
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2015-08
Volume
173
Issue
2
Pages
175-184
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-14-0978
OpenAlex
W2121182679
Cited by
46
References
11
Citations by year
2026: 3 · 2024: 3 · 2023: 9 · 2022: 5 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 2
FWCI
1.45
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (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
congenital adrenal hyperplasia, adult health outcomes, disease control, 17-hydroxyprogesterone, androstenedione, bone mineral density, testicular adrenal rest tumor, adrenal nodules, hyperandrogenism, menstrual irregularity, obesity, fludrocortisone, glucocorticoid dose, total testosterone
MeSH terms
Adolescent, Adrenal Hyperplasia, Congenital, Adult, Cross-Sectional Studies, Female, Health Status, Humans, Male, Middle Aged, Cohort Studies, Biomarkers, Bone Density, Body Mass Index, Treatment Outcome, Young Adult

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