ESPE Abstracts (2018) 89 P-P1-002

Obesity and Cardio-metabolic Risk Factors among Children and Adolescents with Non-Classic 21-Hydroxylase Deficiency

Liat de Vriesa,b, Yael Lebenthala,b, Moshe Phillipa,b, Ariel Tenenbauma,b & Rachel Belloa,b


aThe Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel; bSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel


Background: Increased risk of obesity and cardio-metabolic risk factors were reported in patients with classical congenital adrenal hyperplasia but little is known about adiposity among patients with non-classical congenital adrenal hyperplasia (NCCAH).

Aim: To assess the prevalence of overweight, obesity and cardio-metabolic risk factors among NCCAH patients.

Methods: A cross-sectional retrospective study of 114 NCCAH patients (93 females; mean age at assessment 17.1±6.9 years) diagnosed before age 18. Clinical assessment included anthropometric measurements, body composition (bio-impedance, waist-to-hip ratio) and blood pressure. Laboratory evaluation included fasting glucose, insulin, and lipid profile. Prevalence of overweight/obesity was calculated for the entire cohort. Data of patients in grades 7–12 (n=76) were compared to those of the National Health and Nutrition Survey (grades 7–12).

Results: For the entire cohort rates of overweight and obesity were 21.9% and 11.4% respectively. Prevalence of obesity or obesity+overweight for patients in grades 7–12 was comparable to that in the Israeli population (10.5 vs. 15.1% P=0.24, 34.2 vs. 41.6% P=0.18). No significant difference was found between treated (n=76) and untreated patients (n=38) in any of the metabolic or anthropometric parameters except for lower fat mass in untreated patients: fat in % of body weight - 21.4±8.3 vs. 27.8±6.8, P=0.02. Longer duration of steroid treatment was associated with increased systolic (r=0.26, P<0.05) and diastolic (r=0.31, P<0.01) blood pressure and with higher hip circumference (r=0.54, P<0.0005) but inversely related with BMI-SDS (r=−0.20, P<0.05).

Conclusion: NCCAH diagnosed in childhood (treated or untreated) is not associated with increased risk of overweight, obesity or metabolic derangements.

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