ESPE Abstracts (2014) 82 P-D-2-2-276

Waist-to-Height Ratio, Waist-to-Hip Ratio, Waist Circumference, and BMI in Children and Adolescents with Classical Congenital Adrenal Hyperplasia Due to 21-Hydoxylase Deficiency (CAH)

Helmuth G. Dörr, Michaela Marx, Nadine Herzog, Katja Gassmann, Carolin Pichl & Thomas Völkl


Department of Pediatrics, University of Erlangen, Erlangen, Germany


Background: It has been reported that children with congenital adrenal hyperplasia (CAH) have higher BMI, increased body fat and greater waist-to-hip ratio (WHR) than control children.

Objective and hypotheses: Recently it was speculated that the screening potential of waist-to-height ratio (WHtR) and waist circumference (WC) for cardio-metabolic risk in adults is higher than WHR and BMI.

Method: To review this hypothesis, we studied 43 children and adolescents with classical CAH (21 m, 22 f; ages: 6.9–17.9 years). All patients were healthy except for their underlying disease and did not take any other medication besides their substitution therapy. The study had been approved by the Ethical Committee and was not accompanied by a control group; for data comparison we used published reference values.

Results: (Mean±S.D.): The BMI-SDS of all patients was 0.79±1.29. Sixteen patients (37.2%) had a BMI above the 90th percentile. The BMI SDS of both male and female patients was significantly correlated with the waist circumference (total: r=0.793, P<0.001). Twelve CAH patients (9 m, 3 f; 9 in puberty) had a significantly higher WC of 87.3±15.7 cm and WHR of 0.99±0.04 (P<0.01) in comparison with the other 31 CAH patients (WC: 69.4±12.3; WHR 0.86±0.05). Their BMI-SDS was also significantly higher (1.55±1.06 vs 0.48±1.25). The WHtR of all CAH patients was 0.48±0.08. Sixteen CAH patients (10 m, 6 f; 13 in puberty) had a significantly higher (P<0.01) WHtR of 0.57±0.06 compared with 0.42±0.02 (n=27 CAH patients). Their BMI-SDS was also significantly higher (2.13±0.66 vs −0.12±0.80). The BMI (>90.perc.) was elevated in 8/12 patients with an increased WC and WHR (66.7%), but elevated in all 16 patients with an increased WHtR (100%).

Conclusion: Our data show a good correlation between BMI, WC, WHR and WHtR in children with CAH. All parameters can be used as screening parameters for overweight.

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