ESPE2023 Poster Category 2 Fat, Metabolism and Obesity (17 abstracts)
Can Gender differently affect Growth and Metabolic Syndrome (MetS) Criteria in children with Classic Congenital Adrenal Hyperplasia (CAH)?
Shayma , El Sayed 1 , Ashraf Soliman 2 , Noor Hamed 2 , Fawzia Alyafei 3 , Nada Alaaraj 2 & Shayma Ahmed 2
1University of Alexandria, Alexandria, Egypt. 2Hamad General Hospital, Doha, Qatar. 3Hamad General hospital, Doha, Qatar
we compared gender effect on growth and metabolic control with CAH. Morbidities associated with CAH, including risks of obesity, hypertension, dysglycemia, and dyslipidemia were investigated.
Methods: Data from 30 children with CAH were analyzed retrospectively. They received hydrocortisone (n= 11) or prednisolone (n= 19) and fludrocortisone (0.1: 0.15 mg OD) since early infancy. The mean hydrocortisone dose = 22.5 +/- 7 mg/m2. The growth data was recorded and the different metabolic criteria including fasting glucose, LDL, HDL, triglyceride, and cholesterol, were measured. Growth and metabolic data were compared between males and females.
Results: Comparison between the growth and metabolic data of males (n=11) and females (n – 19) with CAH (table) showed that the dose of steroid to achieve control did not differ among the two groups. Females had slightly higher BMI compared to males. 5 /11 males were overweight and 1/11 obese, while 5/19 females were overweight and 7/19 were obese. Blood pressure (especially diastolic BP) was higher in females versus males. One girl has both systolic and diastolic high BP. Height SDS did not differ between the 2 genders. 2/11 boys and 4/19 girls had HtSDS < -2. The components of the lipogram, fasting glucose, fasting insulin, and HOMA-IR did not differ among the two groups. High cholesterol was detected in 2/11 boys and 3/19 girls. High triglycerides were detected in 1/11 boys and 4/19 girls
| Males n=11 | Age yr | HC mg/m2 | SBP | DBP | HtSDS | BMI |
| Mean | 6.10 | 9.38 | 95.55 | 59.09 | -0.37 | 17.64 |
| SD | 2.89 | 5.23 | 8.40 | 3.85 | 1.43 | 3.00 |
| Females n=19 | ||||||
| Mean | 7.01 | 7.07 | 99.32 | 64.37 | -0.70 | 19.47 |
| SD | 2.62 | 4.51 | 8.60 | 5.19 | 1.55 | 5.22 |
| P-value | 0.3386 | 0.2128 | 0.286 | 0.0096* | 0.557 | 0.28 |
| Males n=11 | 17OHP | Cholesterol | TG | HDL | LDL | F insulin | FBG | HOMA-IR |
| Mean | 2.64 | 157.27 | 69.64 | 54.64 | 86.64 | 5.39 | 71.27 | 0.96 |
| SD | 3.82 | 24.19 | 21.96 | 5.94 | 23.58 | 1.81 | 8.60 | 0.36 |
| Females n=19 | ||||||||
| Mean | 3.01 | 157.42 | 74.58 | 54.74 | 86.26 | 7.10 | 75.37 | 1.26 |
| SD | 2.45 | 31.04 | 26.83 | 11.16 | 27.22 | 6.42 | 10.73 | 0.87 |
| P-value | 0.73 | 1.00 | 0.604 | 1.00 | 1.00 | 0.385 | 0.303 | 0.257 |
Conclusion: Female children with classic CAH on CS treatment for > 5 years had a high rate of obesity and slightly higher BP compared to males. Some of them have high cholesterol and triglycerides. These patients shall be monitored closely for abnormal growth as well as for abnormal metabolic criteria.
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