ECE2014 Oral Communications Adrenal & Thyroid (5 abstracts)
Relationship between final height and cardiometabolic risk and quality of life in adults with congenital adrenal hyperplasia: United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE)
Thang S Han 1 , Gerard S Conway 1 , Nils Krone 2 , D Aled Rees 3 , Roland H Stimson 4 , Wiebke Arlt 2 , Brian R Walker 4 & Richard J Ross 5
1University College London, London, UK; 2University of Birmingham, Birmingham, UK; 3University of Cardiff, Cardiff, UK; 4University of Edinburgh, Edinburgh, UK; 5University of Sheffield, Sheffield, UK.
Background: Treatment of CAH in childhood focuses on growth and development; however the impact of final height (FH) on adult health is not known. We examined the relationship between FH, adiposity, cardiometabolic risk and quality of life (QoL) in a cohort of adult patients.
Methods: Cross-sectional analysis of 199 adults with CAH. FH, waist circumference (WC) and QoL were expressed as z-scores adjusted for mid-parental target height (FHTH) or UK population (FHUK and WCUK).
Results: FH correlated inversely with age (men r=−0.38; women r=−0.26, P<0.01). Men and women had FHTH z-scores −2 and −1 respectively, and both groups had FHUK z-scores −1 below the UK population (P<0.01). In women, FH was shorter in non-SW than SW classic CAH (P<0.05) and in moderately affected genotype group B women than either more severely affected groups Null and A (P<0.01) or mildest group C (P<0.001). Classic CAH patients diagnosed late were shorter than those diagnosed in the first year of life (P<0.05). The shortest CAH patients were 3.4 times (95% CI: 1.4 to 8.0, P=0.006) more likely to have hypertension than the tallest. FH did not associate with insulin sensitivity, lipid profile, adiposity and QoL. CAH patients had WCUK z-score greater than the UK population (P<0.01), and in women those with the largest WC had a 15-fold increased risk of two cardiometabolic risk factors (P<0.001), and 3–6 fold greater impairment of specific QoL SF-36 domains (P<0.05).
Conclusions: Height prognosis has improved over time but delayed diagnosis is associated with shorter stature. Short stature was associated with hypertension but obesity had a greater impact on health than stature. We hypothesise that exposure to high androgens and/or excessive glucocorticoid treatment in childhood could reduce height and program hypertension.
Acknowledgements: CaHASE are grateful to The Clinical Endocrinology Trust for its financial support and the Society for Endocrinology for management of the project.
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