Background: Patients with Congenital Adrenal Hypeplasia (CAH) due to 21-hydroxylasedeficiency need a life-long therapy with glucocorticoids (GCs) and tend to have a clusterof metabolic risk factors, which are consistent with metabolic syndrome (MS). Mostfrequently used GCs are Hydrocortisone (HC) and Prednisone (P), different for bothpharmacodynamic and pharmacokynetic characteristics.Aim: The aim of this study was to evaluate the impact of HC and P on VAI, a newindicator of visceral fat function, and on metabolic profile in CAH patients long termtreated with GC.Materials and Methods: Thirty-two patients (22 F, 10 M, 18-46 yrs), among which 16 (11F, 5 M) treated with HC (dose 10-45 mg/die) and 16 (11 F, 5 M) treated with P (dose 5-15mg/die), were retrospectively enrolled in the study. VAI was calculated according toAmato and colleagues. Metabolic profile was evaluated measuring each component of MS,in line with IDF criteria, as well as the area under the curve (AUC) of glucose and insulinduring 120 min oral glucose tolerance test (OGTT), the homeostasis model assessment ofthe insulin resistance index (HOMA-IR) and the insulin sensitivity index (ISI).Results: Patients treated with P showed higher VAI (p< 0.001), waist circumference(p=0,03), triglycerides (P<0,001), fasting insulin (p= 0,047), AUC for insulin (p=0,001),HOMA-IR (p=0,038) and lower ISI (p=0,038) than patients treated with HC, whereas nosignificant difference was found in total cholesterol, LDL- and HDL-cholesterol, bloodpressure, fasting glucose and AUC for glucose as well as in the prevalence of MS.Conclusion: The results of the current study demonstrated that among CAH patients, longtermtreatment with P is strongly associated with an higher visceral adiposity dysfunctionand insulin resistance compared to treatment with HC.
|Number of pages||1|
|Publication status||Published - 2013|