THE SPECTRUM OF METABOLIC COMPLICATIONS IN CHILDREN AND ADOLESCENTS WITH CONGENITAL ADRENAL HYPERPLASIA PRESENTING IN TERTIARY CARE HOSPITAL

Abstract

Objective: To determine the prevalence and spectrum of metabolic complications among children and adolescents with congenital adrenal hyperplasia (CAH)

Methods: This cross-sectional study was conducted at the Department of Paediatric Endocrinology, The Children's Hospital and University of Child Health Sciences, Lahore, Pakistan from February 2025 to August 2025. Twenty-nine children and adolescents aged 7–18 years with classic CAH receiving regular follow-up were enrolled. Anthropometric measurements, blood pressure, waist circumference, fasting blood glucose, fasting insulin, lipid profile, liver enzymes, abdominal ultrasonography, echocardiography, and serum 17-hydroxyprogesterone levels were assessed.

Results: Twenty-nine patients were included, comprising 17 (58.6%) females and 12 (41.4%) males. Salt-wasting CAH was present in 24 (82.8%) patients, while 5 (17.2%) had the simple virilizing form. Only 8 (27.6%) patients achieved good biochemical disease control. Short stature observed in 12 (41.3%) was most common complication followed by Insulin resistance as the most common metabolic abnormality, affecting 8 (27.6%) participants, followed by dyslipidemia in 5 (17.2%), hypertension in 4 (13.8%), obesity in 7 (24.1%), impaired fasting glucose in 2 (6.9%), and non-alcoholic fatty liver disease in 1 (3.4%). Among female participants, hirsutism was the most common hyperandrogenic manifestation, affecting 9 (52.9%), followed by menstrual irregularities in 6 (35.3%), Two (11.8%) fulfilled the diagnostic criteria for polycystic ovary syndrome(PCOS).

Conclusion: Metabolic complications are common among children and adolescents with CAH, withshort stature and  insulin resistance being the predominant one.