Final Heights in Patients with Congenital Adrenal Hyperplasia: a Retrospective Cohort Study

Congenital adrenal hyperplasia (CAH) attributed to 21-OHD is one of the most common genetic endocrine disorders that occurs due to the disruption and defects in the steroidogenic enzymes involved in the production of cortisol. The current study aims to assess the final height of patients with classic CAH forms in Iran.

The retrospective cohort study was conducted on 30 patients (determined using the previous studies by the sample size formula to compare two means) studies with classic type CAH who were followed up and treated in the endocrinology clinic of Ali Asghar Hospital during the 2000-2022 years. The history of the patients at the time of diagnosis was extracted from the patient's files and recorded in the checklist. All data was analyzed using IBM SPSS Statistics version 22 software.

In the simple virilizing (SV) group, the target and final height for females was 162 and 159.2 cm, and for males were 173 and 171 cm. In the salt-wasting (SW) group, the target and final height for females was 164 and 163.2 cm, and for males were 171.7 and 173.1 cm. There was a significant and reverse correlation between the mean age at the time of diagnosis and the Final Height percentile among all cases (r: -0.55, p: 0.02) and the SW group (r: -0.75, p: 0.002). A positive and significant correlation was seen between the bone age advanced and final height percentile in the SV group (r: 0.04, p: 0.03). The final height percentile increased significantly with an increase in the Duration of treatment regardless of CAH type (r: -0.67, p: 0.009). Also, there was a positive and significant correlation between hydrocortisone dose and final height percentile in the SV group (r: 0.24, p: 0.04).

The results of the present study showed that early diagnosis of the disease at a young age, lower bone age of patients, preventing the increase of obesity in children with CAH, and receiving appropriate drugs with standard doses can play an effective role in increasing the final height of CAH patients.