Introduction: Congenital Adrenal Hyperplasia (CAH) is the commonest cause of Disorder of Sex development (DSD). It is a group of autosomal recessive disorders caused by deficiency of enzymes involved in synthesis of cortisol, aldosterone or both. The combination of hypocortisolism, hyperandrogenism and adrenal medullary hypofunction due to the disease and side effects of steroids treatment may make these individuals more prone to develop cardiovascular disorders including impaired exercise performance and increased systolic blood pressure. Ultrasonographic assessment of Carotid Intima-media Thickness (CIMT) is a well-established examination for screening individuals at cardiovascular risk.
Aim of the work: The aim of this study is to evaluate the cardiovascular risk factors including assessment of biochemical parameters and carotid intima-media thickness in children with congenital adrenal hyperplasia.
Subjects and Methods: This study included thirty children diagnosed with congenital adrenal hyperplasia for 2 years or more attending the endocrinology clinic in Alexandria University Childrens Hospital, Egypt and they were compared with thirty apparently healthy children of matched age and sex. Thorough history taking and clinical examination were done with emphasis on dose and type of steroid used, and anthropometric measurements. Laboratory investigations were done including lipid profile and Insulin resistance index was assessed using homeostatic model assessment (HOMA-IR). High-resolution B-mode ultrasonography was performed to measure the carotid intima-media layer thickness (CIMT) and evaluate the colour Doppler flow characteristics of the carotid arteries.
Results: In the present study, we had 19 females and 11 males with CAH. Their mean age was 6.6 years. No significant difference was found in the age, sex or blood pressure between the cases and controls. About 13% of cases of CAH had high cholesterol levels. It was found that 11 cases had HOMA-IR between 75-95th percentiles and 3 cases above 95th percentiles.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology