Metabolic Syndrome Spectrum in Children with Classic Congenital Adrenal Hyperplasia-A Comprehensive Review

被引：0

作者：

Zaric, Sanja Panic ^{[1
]}

Milenkovic, Tatjana ^{[1
]}

Todorovic, Sladjana ^{[1
]}

Mitrovic, Katarina ^{[1
,2
]}

Cvetkovic, Dimitrije ^{[1
]}

Cehic, Maja ^{[1
]}

Vekic, Jelena ^{[3
]}

Dumic, Katja ^{[4
]}

Vukovic, Rade ^{[1
,2
]}

机构：

[1] Mother & Child Hlth Care Inst Serbia Dr Vukan Cup, Dept Pediat Endocrinol, Belgrade 11070, Serbia

[2] Univ Belgrade, Sch Med, Belgrade 11000, Serbia

[3] Univ Belgrade, Fac Pharm, Dept Med Biochem, Belgrade 11221, Serbia

[4] Univ Zagreb, Univ Hosp Ctr Zagreb, Sch Med, Dept Pediat Endocrinol & Diabet, Zagreb 10000, Croatia

来源：

METABOLITES | 2025年 / 15卷 / 02期

关键词：

classical congenital adrenal hyperplasia; children; metabolic syndrome; metabolic health; cardiometabolic; cardiovascular; hypertension; obesity; insulin resistance; dyslipidemia; CARDIOVASCULAR RISK-FACTORS; INTIMA-MEDIA THICKNESS; BLOOD-PRESSURE; 21-HYDROXYLASE DEFICIENCY; YOUNG-PATIENTS; ADOLESCENTS; DISEASE; PROFILE; OBESITY; HEALTH;

D O I：

10.3390/metabo15020089

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

Children with a classic form of congenital adrenal hyperplasia (CCAH) have a potentially increased risk of unfavorable cardiometabolic events due to the interplay of corticosteroid treatment, hyperandrogenism, and other factors. Although readily recognized in adults, these aspects are frequently overlooked in children and youth with CCAH; Aim: To review the evidence available from studies regarding cardiometabolic health outcomes in CCAH patients; Methods: A review of the literature was performed following PRISMA guidelines, including studies published between 2000 and 2024. We included studies reporting cardiometabolic outcomes in children and adolescents (<18 years) with CCAH. Where pediatric data were sparse, additional data were obtained from studies with older adolescents and young adults (15-25 years). Cardiometabolic outcomes included risk factors, such as obesity, insulin resistance, lipids, blood pressure, and vascular markers; Results: Twenty-five studies were analyzed. The prevalence of obesity was found to be higher in children with CCAH, as well as of increased visceral adiposity. Higher indices of insulin resistance were also a frequent finding in children with CCAH. CCAH patients had higher systolic blood pressure and more frequently loss of nocturnal blood pressure dipping, particularly among salt-wasting subtypes and in younger children. Subclinical atherosclerosis was indicated by increased carotid intima-media thickness, elevated hs-CRP, and impaired endothelial function. Other findings suggested changes in lipid profiles, particularly decreased HDL-c and increased triglycerides, although the findings were less consistent; Conclusions: Compared with the general pediatric population, children with CCAH were found to have an increase in multiple cardiometabolic risk factors. It is therefore vital to monitor these risk factors in pediatric CCAH, as well as tailoring treatment with cardiometabolic health in mind, to achieve better long-term cardiovascular and metabolic outcomes. Future research should focus on longitudinal studies of cardiometabolic outcomes and innovative therapeutic approaches to reduce these risks in patients with CCAH.

引用

页数：17

共 55 条

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