IMPE Abstracts

Background: Recent research has indicated an association between patients with CAH and higher incidence of obesity associated with cardiovascular risk. Individuals with congenital adrenal hyperplasia suffers from 21-hydroxylase deficiency, which leads to lack of cortisol and aldosterone, causing androgen excess. Early diagnosis and treatment are essential to prevent morbidity and mortality, both of which are increased on CAH patients in comparison to population in general. Therefore, we sought to evaluate the frequency between ponderal gain in children and teenager and hormonal control combined with corticosteroid therapy.

Methods: It’s a retrospective study of data gathering from patients record of children and teenagers (until 18 years old) with CAH caused by 21-OH deficiency (salt-wasting and simple-virilizing forms, diagnosed with higher baselines value of 17OHP, with current medical follow-up at Hospital Central da Santa Casa de São Paulo. Were excluded patients with incomplete record data and with physical deformity that difficult height measurement. The data collected are: form of CAH, age of diagnosis, type of corticosteroid therapy and dose management, current height and weight for BMI calculation, pubertal staging (according to Tanner stage), 17OHP, androstenedione and testosterone levels. Both BMI and stature were expressed in z score, considering overweight for BMI, z> +1 and <+2DP, obesity>+2 and <+3DP and severe obesity >+3DP (WHO, 2007).

Results: Were included 28 patients (15M and 13F), all of them diagnosed when newborn. The average (DP) Chronological Age (IC) was 10,1 (4,1) y, from BMI z 1,2 (1,2), BA 11,7 (2,9)y, 17OHP: 23,9 (26,6) ng/ml, androstedione 2,6 (2,8) ng/ml, prednisole dose: 5,4 (2,3) mg/m2/d. 5 of patients using dexamethasone, with a mean dose (SD) of 0.5 (0.6)mg/day.

16/28 with overweight: 57,1%

Obesity: 6/28: 21,4%

Overweight: 10/28: 35,7% When we compared the eutrophic x overweight groups, there was no difference in terms of gender, Chronological Age (IC), laboratory variables or those of glucocorticoids.

Conclusion: We found a high percentage of overweight in pediatric patients with CAH. Due to the increased risk of cardiovascular disease, obesity prevention is important in this group. We found no correlation between excess weight and glucocorticoid dose. More longitudinal studies are needed.