Adult Patients with Congenital Adrenal Hyperplasia Have Elevated Blood Pressure but Otherwise a Normal Cardiovascular Risk Profile

PLoS One

Fred C. G. J. Sweep¹  Christiaan F. Mooij¹  Ad R. M. M. Hermus²  Cees J. Tack³  Jeanne Margot Kroese⁴ 

[1] Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Laboratory Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Paediatric Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

关键词: Blood pressure;    Congenital adrenal hyperplasia;    Adiponectin;    Cholesterol;    Cortisol;    Insulin;    Lipid profiles;    Insulin resistance;   

DOI  :  10.1371/journal.pone.0024204

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Objective Treatment with glucocorticoids and mineralocorticoids has changed congenital adrenal hyperplasia (CAH) from a fatal to a chronic lifelong disease. Long-term treatment, in particular the chronic (over-)treatment with glucocorticoids, may have an adverse effect on the cardiovascular risk profile in adult CAH patients. The objective of this study was to evaluate the cardiovascular risk profile of adult CAH patients. Design Case-control study. Patients and Measurements In this case-control study the cardiovascular risk profile of 27 adult CAH patients and 27 controls, matched for age, sex and body mass index was evaluated by measuring ambulatory 24-hour blood pressure, insulin sensitivity (HOMA-IR), lipid profiles, albuminuria and circulating cardiovascular risk markers (PAI-1, tPA, uPA, tPA/PAI-1 complex, hsCRP, adiponectin, IL-6, IL-18 and leptin). Results 24-Hour systolic (126.3 mmHg±15.5 vs 124.8 mmHg±15.1 in controls, P = 0.019) and diastolic (76.4 mmHg±12.7 vs 73.5 mmHg±12.4 in controls, P<0.001) blood pressure was significantly elevated in CAH patients compared to the control population. CAH patients had higher HDL cholesterol levels (P<0.01), lower hsCRP levels (P = 0.03) and there was a trend toward elevated adiponectin levels compared to controls. Other cardiovascular risk factors were similar in both groups. Conclusion Adult CAH patients have higher ambulatory blood pressure compared to healthy matched controls. Other cardiovascular risk markers did not differ, while HDL-cholesterol, hsCRP and adiponectin levels tended to be more favorable.

【 授权许可】

CC BY