Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil,
Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Arch Endocrinol Metab. 2023 Jan 18;67(1):64-72. doi: 10.20945/2359-3997000000504. Epub 2022 Aug 4.
Herein, we compared ambulatory blood pressure (ABP) between young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency and a control group. Additionally, we analyzed correlations between the glucocorticoid dose and androgen levels and ABP parameters.
This case-control study included 18 patients (6 males and 12 females) and 19 controls (8 males and 11 females) matched by age (18-31 years). ABP monitoring was used to estimate blood pressure (BP) over a 24-h period.
No difference was noted between patients and controls in terms of systolic BP (males, 115.5 ± 5.6 117.0 ± 9.3, = 0.733; and females, 106.4 ± 7.9 108.4 ± 7.6, = 0.556, respectively) and diastolic BP during 24 h (males, 62.8 ± 7.5 66.2 ± 5.6, = 0.349; and females, 62.7 ± 4.9 62.3 ± 4.9, = 0.818, respectively). Systolic and diastolic BP and pulse pressure during daytime and nocturnal periods were similar between patients and controls. Furthermore, no differences were detected in the percentage of load and impaired nocturnal dipping of systolic and diastolic BP between patients and controls during the 24-h period. Additionally, the glucocorticoid dose (varying between = -0.24 to 0.13, > 0.05) and androgens levels (varying between = 0.01 to 0.14, > 0.05) were not associated with ABP parameters.
No signs of an elevated risk for hypertension were observed based on ABP monitoring in young adults with CAH attributed to 21OHase deficiency undergoing glucocorticoid replacement therapy.
本研究旨在比较患有 21-羟化酶（21OHase）缺乏症的先天性肾上腺皮质增生症（CAH）的年轻患者与对照组之间的动态血压（ABP）。此外，我们还分析了糖皮质激素剂量和雄激素水平与 ABP 参数之间的相关性。
本病例对照研究纳入了 18 例患者（6 名男性和 12 名女性）和 19 例对照组（8 名男性和 11 名女性），两组年龄匹配（18-31 岁）。采用 24 小时动态血压监测来评估血压。
在男性患者（收缩压 115.5±5.6 与 117.0±9.3， = 0.733）和女性患者（收缩压 106.4±7.9 与 108.4±7.6， = 0.556）中，患者与对照组之间的 24 小时收缩压以及白天和夜间的舒张压无差异。在男性患者（舒张压 62.8±7.5 与 66.2±5.6， = 0.349）和女性患者（舒张压 62.7±4.9 与 62.3±4.9， = 0.818）中，患者与对照组之间的 24 小时舒张压以及白天和夜间的收缩压也无差异。此外，患者与对照组之间在 24 小时期间的收缩压和舒张压的负荷百分比和夜间下降受损无差异。此外，糖皮质激素剂量（变化范围为 = -0.24 至 0.13， > 0.05）和雄激素水平（变化范围为 = 0.01 至 0.14， > 0.05）与 ABP 参数均无相关性。
在接受糖皮质激素替代治疗的患有由 21OHase 缺乏引起的 CAH 的年轻患者中，通过 ABP 监测未观察到高血压风险增加的迹象。
