Endocrine Abstracts

Background: Several studies suggest health problems in adult patients with CAH. However, data is inconsistent and based on small and relatively young cohorts.

The aim of this study was to analyze the metabolic and cardiovascular health in a cohort of 90 adult patients with classic CAH.

Subjects and methods: Participants included 90 patients with classic CAH: age range 18–62 years (mean 32.9±10.5, median 29.2) 39 male, 51 female, 61 salt wasting, 29 simple virilising and 90 healthy controls matched for age, sex, BMI and smoking-habit. Anthropometric, metabolic, and subjective health status was evaluated (including measurement of intima media thickness of the common carotid artery, analysis of the body composition by bioimpedance analysis (BIA) and 24 hour ambulatory blood pressure).

Results: There was no significant difference in intima-media-thickness of the common carotid artery between patients and healthy subjects (median 0.60±0.08 mm versus 0.64±0.09 mm, P=0.067 for the right side and median 0.060±0.10 mm versus median 0.61±0.09 mm, P=0.653 for the left side). Patients showed increased BMI (mean 27.0 kg/m² versus 25.9 kg/m²) compared to the general German population. Patients were significantly shorter (median 1.64±0.09 m versus 1.73±0.09 m, P≤0.001), both male and female had increased body fat mass in proportion to lean body mass (median 0.41±0.22 versus 0.29±0.10, P≤0.001 for male and median 0.61±0.24 versus 0.49±0.19, P=0.008) compared to the control group. 24-hour blood-pressure measurements showed an impaired nocturnal drop, 54% of patients showed increased nocturnal systolic blood pressures, 17% had elevated systolic and diastolic blood pressures during the night time and were classified as non-dippers (systolic nocturnal drop: median 9.8±5.3%, diastolic nocturnal drop: median 15.7±6.6%)

Conclusion: Patients with classic CAH are at substantially higher metabolic and cardiovascular risk compared to a healthy control group. Better prevention strategies need to be employed.