OBJECTIVE:The objective of this study was to evaluate patients with classic CAH before and after treatment with glucocorticoids/mineralocorticoid and compare the metabolic profile of the well controlled (WC) and poorly controlled (PC) group. SUBJECTS AND METHODS:We selected newly diagnosed patients and patients monitored for CAH, classical form, regularly using or not glucocorticoids/mineralocorticoid in the Genetics Service Hupes-UFBA, seen from March/2004 to May/2006. All patients underwent detailed clinical evaluation and laboratory tests (glucose, sodium and potassium; total cholesterol, HDL, LDL, triglycerides and uric acid; leptin, 17-hydroxyprogesterone, total testosterone, C peptide, and insulin). Patients with normal androgens were classified as well controlled (WC), and those with high levels of androgens either using or not glucocorticoids/mineralocorticoids were classified as poorly controlled (PC). RESULTS:We studied 41 patients with CAH: 11 in the WC group and 30 in PC group. Leptin and LDL cholesterol levels were higher in WC than in the PC group (p < 0.05). Uric acid values were lower in WC compared with the PC group (p < 0.05). CONCLUSION:Adequate control of CAH with steroids seems safe, as it is associated with only mild changes in lipid profile and leptin values. No other metabolic abnormality was associated with glucocorticoid use. The reason for lower uric acid levels found in WC CAH patients is unknown and should be further studied.

译文

目的:本研究的目的是评估糖皮质激素/盐皮质激素治疗前后的经典CAH患者,并比较控制良好(WC)和控制不良(PC)组的代谢特征。
研究对象和方法:从2004年3月/ 2006年5月至2006年5月,我们选择了遗传学服务部门Hupes-UFBA中定期使用或不使用糖皮质激素/矿物质皮质激素的新诊断患者和常规形式的CAH监测患者。所有患者均接受了详细的临床评估和实验室测试(葡萄糖,钠和钾;总胆固醇,HDL,LDL,甘油三酸酯和尿酸;瘦素,17-羟基孕酮,总睾丸激素,C肽和胰岛素)。具有正常雄激素的患者被分类为控制良好(WC),而那些使用或不使用糖皮质激素/矿物质皮质激素的雄激素水平高的患者被分类为控制不良(PC)。
结果:我们研究了41例CAH患者:WC组11例,PC组30例。 WC中的瘦素和LDL胆固醇水平高于PC组(p <0.05)。与PC组相比,WC中的尿酸值较低(p <0.05)。
结论:用类固醇充分控制CAH似乎是安全的,因为它仅与脂质分布和瘦素值的轻度变化有关。没有其他代谢异常与糖皮质激素的使用有关。在WC CAH患者中发现尿酸水平降低的原因尚不清楚,应进一步研究。

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