Kara Zehra, Demir Ahmet Numan, Sulu Cem, Durcan Emre, Uysal Serhat, Turan Hande, Özkaya Hande Mefkure, Evliyaoğlu Saadet Olcay, Ercan Oya, Gönen Mustafa Sait
Department of Endocrinology, Metabolism and Diabetes and Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey.
Department of Pediatric Endocrinology, Cerrahpasa Medical Faculty, University of İstanbul-Cerrahpasa, Istanbul, Turkey.
Metab Syndr Relat Disord. 2023 Feb;21(1):35-40. doi: 10.1089/met.2022.0060. Epub 2022 Dec 20.
To evaluate the cardiometabolic risk in patients with CAH (21 (OH) enzyme deficiency) on the basis of the visceral adiposity index (VAI), which indicates dysfunction of the visceral adipose tissue (VAT). A total of 41 patients and 38 body mass index (BMI), age, and gender-matched healthy controls (HC) were included. The patients' and HCs' age, gender, waist circumference (WC), BMI information and total cholesterol (TC), high-density lipoprotein (HDL), triglyceride (TG) values, smoking, and medication history were obtained from medical charts. Weight, height, WC, and blood pressure levels were measured. Patients' and HCs' BMI, Framingham risk scores (FRS), VAI and Ferriman-Gallwey scores were calculated. The patients' and HCs' age, gender TC, HDL, and TG, androstenedione, dehydroepiandrosterone sulfate (DHEASO), 17 hydroxyprogesterone (17(OH)P) values, smoking, and medication history were obtained from medical charts. Body fat and muscle mass levels were measured with Tanita T 6360. Gender distribution, mean age, and BMI of patients with CAH were 34/7, 30 ± 8, 27 ± 5.4; HC subjects 30/8, 30 ± 6, 27 ± 3.8 ( = 0.9, 0.6, 0.9, respectively). The VAI values of patients with a diagnosis of CAH 3.7 (2.3-6.9) were found to be significantly higher than those of HC patients 2.5 (1.8-3.9; = 0.02). The mean glucocorticoid doses of the patients were 17 ± 9 mg/day. The glucocorticoid dose level was determined as independent risk factor on the FRS ( = 0.03, β = 0.04) and VAI ( = 0.018, β = 0.17). Glucocorticoid dose optimization should be done more carefully to improve metabolic and cardiovascular outcomes in CAH patients.
基于内脏脂肪组织（VAT）功能障碍的指标——内脏脂肪指数（VAI），评估先天性肾上腺皮质增生症（CAH，21羟化酶缺乏症）患者的心脏代谢风险。共纳入41例患者和38例体重指数（BMI）、年龄及性别匹配的健康对照者（HC）。从病历中获取患者和健康对照者的年龄、性别、腰围（WC）、BMI信息以及总胆固醇（TC）、高密度脂蛋白（HDL）、甘油三酯（TG）值、吸烟情况和用药史。测量体重、身高、WC和血压水平。计算患者和健康对照者的BMI、弗雷明汉风险评分（FRS）、VAI和费里曼 - 加韦评分。从病历中获取患者和健康对照者的年龄、性别、TC、HDL、TG、雄烯二酮、硫酸脱氢表雄酮（DHEASO）、17羟孕酮（17(OH)P）值、吸烟情况和用药史。使用Tanita T 6360测量体脂和肌肉量水平。CAH患者的性别分布、平均年龄和BMI分别为34/7、30±8、27±5.4；健康对照者为30/8、30±6、27±3.8（分别为0.9、0.6、0.9）。诊断为CAH的患者的VAI值为3.7（2.3 - 6.9），显著高于健康对照患者的2.5（1.8 - 3.9；P = 0.02）。患者的糖皮质激素平均剂量为17±9毫克/天。糖皮质激素剂量水平被确定为FRS（P = 0.03，β = 0.04）和VAI（P = 0.018，β = 0.17）的独立危险因素。应更谨慎地进行糖皮质激素剂量优化，以改善CAH患者的代谢和心血管结局。
