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Cardiovascular Risk in Women With Nonclassical Congenital Adrenal Hyperplasia.

Fernanda Cavalieri Costa1, Larissa Garcia Gomes1, Thais Martins de Lima2

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Cardiovascular risk in nonclassical congenital adrenal hyperplasia (NCAH) patients is not elevated by standard treatments. While dexamethasone increased inflammatory markers, it did not correlate with atherosclerosis in young adults.

Keywords:
cardiovascular riskcarotid intima media thicknessendothelial functionnonclassical congenital adrenal hyperplasiapulse wave velocityvisceral fat

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Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Disorders

Background:

  • Cardiovascular risk (CVR) in nonclassical congenital adrenal hyperplasia (NCAH) remains largely unknown, particularly concerning treatments like low-dose glucocorticoids or oral contraceptive pills.
  • Understanding CVR in NCAH is crucial for managing long-term health outcomes in affected individuals.

Purpose of the Study:

  • To investigate cardiovascular risk markers of atherosclerosis in females with NCAH.
  • To compare CVR markers based on different therapeutic options: dexamethasone, oral contraceptive pills, or no treatment.

Main Methods:

  • A cross-sectional study involving 47 females with NCAH and 30 controls.
  • Assessment of CVR through serum lipids, HOMA-IR, inflammatory cytokines (IL-6, IL-8), pulse wave velocity (PWV), endothelial function (FMD), carotid intima media thickness (CIMT), and visceral adipose tissue (VAT).

Main Results:

  • No significant differences were observed in BMI, HOMA-IR, HDL-cholesterol, or triglyceride levels among the groups.
  • Higher levels of IL-6 and IL-8 were found in patients treated with dexamethasone compared to other groups.
  • No significant differences in VAT, PWV, FMD, or CIMT were detected among the study groups.

Conclusions:

  • Adult females with NCAH, even when treated, do not exhibit increased cardiovascular risk markers for precocious atherosclerosis.
  • Elevated IL-6 and IL-8 levels in patients on dexamethasone were not associated with radiological markers of atherosclerosis.
  • Long-term follow-up is recommended for this cohort of young adults to monitor potential cardiovascular changes.