Unfavourable trends in cardiovascular and metabolic risk in paediatric and adult patients with congenital adrenal hyperplasia?

Clin Endocrinol (Oxf). 2010 Aug;73(2):137-46. doi: 10.1111/j.1365-2265.2009.03690.x. Epub 2009 Aug 29.

Abstract

Context: As a result of the introduction of treatment with glucocorticoids and mineralocorticoids, now 60 years ago, congenital adrenal hyperplasia has become a lifelong chronic disease. Whether long-term treatment of the disease leads to long-term side effects remains unknown. In this respect, especially cardiovascular risk seems to be important.

Evidence synthesis: We reviewed the reported prevalence of conventional cardiovascular risk factors, i.e. obesity, insulin resistance, high blood pressure and dyslipidaemia in patients with congenital adrenal hyperplasia. Overall, the studies suggest a tendency towards an increased body mass index and fat mass, the presence of insulin resistance and hypertension, although data are relatively scarce and obtained in heterogeneous populations.

Conclusions: Our findings suggest that adult CAH patients tend to have a cluster of metabolic risk factors, which are consistent with the metabolic syndrome. This notion may have consequences for the care for this group of patients.

Publication types

  • Evaluation Study
  • Review

MeSH terms

  • Adrenal Hyperplasia, Congenital / complications*
  • Adrenal Hyperplasia, Congenital / drug therapy
  • Adrenal Hyperplasia, Congenital / epidemiology
  • Adrenal Hyperplasia, Congenital / pathology
  • Adult
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Child
  • Disease Progression
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Long-Term Care
  • Metabolic Diseases / epidemiology
  • Metabolic Diseases / etiology*
  • Risk Factors
  • Time Factors

Substances

  • Glucocorticoids