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Cited by 34Sexual Differentiation and DisordersAdrenal Hormones and DisordersHormonal Regulation and Hypertension

Cardiovascular health in children and adolescents with congenital adrenal hyperplasia due to 21-hydroxilase deficiency

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Improda, Nicola, Barbieri, Flavia, Ciccarelli, Gian Paolo, Capalbo, Donatella, Salerno, Mariacarolina·2019·Frontiers in Endocrinology
DOI 10.3389/fendo.2019.00212PMC PMC6470198
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Abstract

Increasing evidence indicates that adults with Congenital Adrenal Hyperplasia (CAH) may have a cluster of cardiovascular (CV) risk factors. In addition, ongoing research has highlighted that children and adolescents with CAH are also prone to developing unfavorable metabolic changes, such as obesity, hypertension, insulin resistance, and increased intima-media thickness, which places them at a higher risk of developing CV disease in adulthood. Moreover, CAH adolescents may exhibit subclinical left ventricular diastolic dysfunction and impaired exercise performance, with possible negative consequences on their quality of life. The therapeutic management of patients with CAH remains a challenge and current treatment regimens do not always allow optimal biochemical control. Indeed, overexposure to glucocorticoids and mineralocorticoids, as well as to androgen excess, may contribute to the development of unfavorable metabolic and CV abnormalities. Long-term prospective studies on large cohorts of patients will help to clarify the pathophysiology of metabolic alterations associated with CAH. Meanwhile, further efforts should be made to optimize treatment and identify new therapeutic approaches to prevent metabolic derangement and improve long-term health outcomes of CAH patients.

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  • Results for carotid intima media thickness (cIMT), a surrogate marker of cardiac dysfunction, vary in existing studies, without correlation between cIMT and cumulative glucocorticoid doses or androgen levels.

    “Results for carotid intima media thickness (cIMT), a surrogate marker of cardiac dysfunction, vary in existing studies (677,678,683), without correlation between cIMT and cumulative glucocorticoid doses or androgen levels (683).”

    From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [683]

    The Vascular Function and Intima-Media Thickness section reports contrasting cIMT results across studies, but it also reports correlations between cIMT and androgen-related measures, including androstenedione and testosterone. It describes IMT as a surrogate marker of atherosclerosis, not cardiac dysfunction. Its reported correlation with cumulative glucocorticoid dose concerns aortic IMT, not cIMT. (LLM, conf=0.89)

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References 70 · Cited by 34

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Authors
Improda, N., Barbieri, F., Ciccarelli, G. P., Capalbo, D., & Salerno, M.
Affiliations
  • University of Naples Federico II (IT)
  • Federico II University Hospital (IT)
Corresponding author
Salerno, Mariacarolina
ORCID
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2019-04-11
Volume
10
Pages
212-212
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2019.00212
PMC
PMC6470198
OpenAlex
W2938426775
Cited by
34
References
70
Citations by year
2026: 6 · 2025: 9 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 2 · 2019: 1
FWCI
0.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
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 › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
congenital adrenal hyperplasia, 21-hydroxylase deficiency, cardiovascular risk, children and adolescents, obesity, hypertension, insulin resistance, intima-media thickness, left ventricular diastolic dysfunction, exercise performance, hyperandrogenism, metabolic disorders, quality of life

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