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Congenital adrenal hyperplasia tied to overweight, obesity risk
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Children with congenital adrenal hyperplasia have an increased risk for overweight or obesity compared with healthy children, but rates of persistent obesity may be lower than previously thought, according to recent data.
Kyriakie Sarafoglou, MD, director of the Leo Fung Center for Congenital Adrenal Hyperplasia and Disorders of Sex Development, University of Minnesota Masonic Children’s Hospital in Minneapolis, and colleagues evaluated 194 children diagnosed with congenital adrenal hyperplasia (CAH) born after 1970 to determine associations of obesity and overweight with glucocorticoids, fludrocortisone and disease control.
Overall, 124 participants had the salt-wasting form of CAH, and 70 had the simple-virilizing form.
Half of participants had BMI of at least the 95th percentile for their age, sex and standard criterion for obesity on at least one occasion, and 70% had BMI of at least the 85th percentile. When BMI for height-age was used, the prevalence of obesity decreased from 47% to 43% in participants with salt-wasting CAH and from 50% to 33% in participants with simple-virilizing CAH.
Persistent obesity (obesity at three clinic visits) was present in 6% of participants with salt-wasting and 1% of participants with simple-virilizing CAH, whereas persistent overweight was present in 35% of participants with salt-wasting CAH and 33% of participants with simple-virilizing CAH.
Adiposity rebound (BMI nadir) occurred in participants with salt-wasting CAH by 3.3 years and in participants with simple-virilizing CAH by 3.8 years, earlier than it occurs in healthy children.
“CAH children are at higher risk for earlier adiposity rebound, increased early-onset obesity and overweight, regardless of subtype,” the researchers wrote. “Avoiding over-suppression and increasing BMI over the first 5 years of life is especially important as chronic exposure to glucocorticoids may increase the risk of earlier adiposity rebound and increased risk of obesity during adulthood.” – by Amber Cox
For more information:
Kyriakie Sarafoglou, MD, can be reached at University of Minnesota Masonic Children’s Hospital, 2450 Riverside Avenue, East Building, Room MB671, Minneapolis, MN 55454; email: saraf010@umn.edu.
Disclosure: The researchers report no relevant financial disclosures.
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