Department of Pediatric Endocrinology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
Department of Pediatric Radiology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
Turk J Med Sci. 2021 Aug 30;51(4):1738-1746. doi: 10.3906/sag-2001-57.
BACKGROUND/AIM: We aimed to determine the presence of subclinical atherosclerosis using carotid intima-media thickness (CIMT) and biochemical parameters in children and adolescents with congenital adrenal hyperplasia (CAH).
Thirty-four patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency on regular glucocorticoid treatment for ≥3 years and 31 healthy subjects were included in the study. The patients were divided into two groups according to the degree of control of the clinic, laboratory, and radiological parameters as a) “uncontrolled” [n= 22; with increased height velocity (HV) standard deviation score (SDS) (≥2 SDS), advanced bone age, serum 17-OH progesterone <2.0 and ≥10.0 ng/mL or androstenedione <0.3 and ≥ 3.0 ng/mL] or b) “controlled” [n= 12; with HV SDS < 2, bone age (BA)/ chronologic age (CA) ratio < 1.2, serum 17-OH progesterone between 2 and 10 ng/mL and androstenedione between 0.3 and 3.0 ng/mL]. Ultrasonographic examination of carotid artery was performed by the same radiologist using a B-mode ultrasound system.
There was no significant difference between the CAH and control groups in terms of median (IQR) CIMT values [0.47 (0.05) mm and 0.47 (0.07) mm, respectively; p > 0.05]. When subgroup comparisons were done in terms of median (IQR) CIMT values, there was no significant difference among the controlled, uncontrolled, and healthy control groups [0.45 (0.03) mm, 0.47 (0.04) mm, 0.47 (0.07) mm, respectively; p> 0.05]. In addition, CIMT levels were similar according to sex and disease control status.
In this study, the CIMT values of CAH cases were similar to those of healthy subjects.
背景/目的:我们旨在通过颈动脉内膜中层厚度(CIMT)和生化参数来确定接受常规糖皮质激素治疗≥3 年的先天性肾上腺皮质增生症(CAH)患儿和青少年的亚临床动脉粥样硬化的存在情况。
本研究纳入了 34 例因 21-羟化酶缺乏症而患有经典先天性肾上腺皮质增生症的患者,这些患者正在接受常规糖皮质激素治疗,其中 22 例(无控制组)表现为身高速度标准偏差评分(HV SDS)升高(≥2 SDS)、骨龄提前、血清 17-羟孕酮<2.0 和≥10.0ng/mL 或雄烯二酮<0.3 和≥3.0ng/mL,12 例(控制组)表现为 HV SDS<2、骨龄(BA)/实际年龄(CA)比<1.2、血清 17-羟孕酮在 2 至 10ng/mL 之间、雄烯二酮在 0.3 至 3.0ng/mL 之间。由同一位放射科医生使用 B 型超声系统对颈动脉进行超声检查。
CAH 组和对照组的颈动脉内膜中层厚度(CIMT)中位数(IQR)值分别为 0.47(0.05)mm 和 0.47(0.07)mm,差异无统计学意义(p>0.05)。在按 CIMT 中位数(IQR)值进行的亚组比较中,控制组、无控制组和健康对照组之间差异无统计学意义[0.45(0.03)mm、0.47(0.04)mm、0.47(0.07)mm,分别;p>0.05]。此外,CIMT 水平与性别和疾病控制状态无关。
在这项研究中,CAH 患者的 CIMT 值与健康受试者相似。