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Leptin and adiponectin in children and young persons with congenital adrenal hyperplasia

Irina Bacila1, Neil Richard Lawrence1, Sabah Alvi2

  • 1Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Western Bank, Sheffield S10 2TH, United Kingdom.

European Journal of Endocrinology
|August 12, 2025
PubMed

Insights

Congenital adrenal hyperplasia (CAH) patients show decreased leptin with hydrocortisone dose, impacting hunger and satiety. Adiponectin levels in CAH correlate with androgen levels, indicating potential metabolic risk.

Area of Science:

  • Endocrinology
  • Pediatric Endocrinology
  • Metabolic Disorders

Background:

  • Congenital adrenal hyperplasia (CAH) is linked to metabolic complications.
  • Adipokines like adiponectin, leptin, and resistin play roles in metabolic regulation.
  • Understanding these hormones in CAH is crucial for managing associated risks.

Purpose of the Study:

  • To investigate adiponectin, leptin, and resistin levels in children with CAH.
  • To correlate adipokine levels with Body Mass Index (BMI), treatment, and hormonal/metabolic markers.
  • To explore the relationship between hydrocortisone dosage and adipokine levels in CAH.

Main Methods:

  • A cohort of 101 children with 21-hydroxylase deficiency CAH was studied.
  • 83 sex- and age-matched healthy children served as controls.
  • Fasted blood samples were analyzed for adipokines, hormonal, and metabolic markers after the first daily glucocorticoid dose.

Main Results:

  • Leptin was higher in male CAH patients compared to controls.
  • Leptin positively correlated with BMI-SDS in both groups; adiponectin negatively correlated with BMI only in CAH patients.
  • Leptin decreased with increasing first daily hydrocortisone dose in CAH patients.
  • Adiponectin levels decreased with higher concentrations of steroid precursors and androgens in CAH patients.

Conclusions:

  • Decreased leptin with hydrocortisone dose suggests glucocorticoid effects on appetite regulation in CAH.
  • Reduced adiponectin in CAH patients with elevated androgens may serve as a marker for poor hormonal control and metabolic risk.
Abstract

Keywords:
adiponectinandrogenscongenital adrenal hyperplasiaglucocorticoid treatmentleptin

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