Pelin ÇELİK BABALIOĞLU, Melikşah KESKİN, Zehra AYCAN

Konjenital adrenal hiperplazi tanılı çocuk ve adolesanlarda farklı metabolik sendrom tanı kriterlerine göre metabolik sendrom sıklığı: tek merkez çalışması

Amaç: Çalışmanın amacı 21 hidroksilaz eksikliğine bağlı konjenital adrenal hiperplazi tanısı olan çocuk ve adolesanlarda farklı metabolik sendrom tanı kriterlerine göre metabolik sendrom prevelansını belirlemektir.Gereç ve Yöntemler: Çalışmaya konjenital adrenal hiperplazisi tanısı olan toplam 45 hasta (21 hidroksilaz eksikliğine bağlı klasik konjenital adrenal hiperplazi tanısı olan 31 hasta, non klasik konjenital adrenal hiperplazi tanısı alan 14 hasta) dahil edildi. Hastaların antropometrik ölçümleri, klinik değerlendirmeleri, hormonal sonuçları ve hidrokortizon dozu tanı anından çalışmanın başladığı tarihe kadar incelendi ve izlemdeki metabolik durumları (iyi-kötü) belirlenen kriterlere göre değerlendirildi. Son vizitte, hastaların sistemik ve antropometrik değerlendirmeleri (boy, kilo, bel çevresi ve kan basıncı ölçümlerini içeren) aynı tecrübeli klinisyen tarafından yapıldı. Hastaların serum lipid düzeyleri ölçüldü ve hastalara oral glukoz tolerans testi uygulandı. WHO, IDF ve NCEP ATP III modifiye kriterlerine göre metabolik sendrom prevalansı hesaplandı.Bulgular: Çalışmamızda modifiye WHO kriterlerine göre yalnızca 1 (2,2%) hastada, NCEP ATP III kriterlerine göre ise 8 (17,8%) hastaya metabolik sendrom tanısı konuldu. IDF kriterlerine göre 10 yaş üstü 30 hastadan 1’ine (3,3%) metabolik sendrom tanısı konulur iken 6-10 yaş arası hastaların 20%’ sinin metabolik sendrom gelişimi için risk altında olduğu saptandı. Sonuç: Konjenital adrenal hiperplazi tanılı çocuk ve adolesan hastalarda NCEP ATP III metabolik sendrom tanı kriterleri kullanıldığında en yüksek oranda metabolik sendrom sıklığı saptanmıştır.

Anahtar Kelimeler:

Metabolik sendrom, konjenital adrenal hiperplazi, 21-hidroksilaz eksikliği

Prevalence of metabolic syndrome according to different metabolic syndrome definitions in children and adolescents with congenital adrenal hyperplasia: a single center study

Aim: The aim of this study was to investigate the prevalence of metabolic syndrome according to different metabolic syndrome definitions in children and adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Material and Methods: A total number of 45 patients (31 patients with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency and 14 patients with non-classical congenital adrenal hyperplasia) were enrolled to the study. The anthropometric, clinical, hormonal findings and the dose of hydrocortisone were analyzed starting from the initial day of diagnosis until the beginning of our study and the metabolic controls (good-bad) were evaluated in the follow-up period. At the last visit, systemic and anthropometric examinations (involving measures of height, weight, waist circumference and blood pressure) was performed by the same physician. Serum lipid levels were examined and oral glucose tolerance tests were performed. Metabolic syndrome prevalence in our patients was calculated with respect to the modified criteria of WHO, IDF and NCEP ATP III. Results: Metabolic syndrome was diagnosed in only 1 (2.2%) of the 45 patients in the study according to modified WHO definition, 8 patients (17.8%) received a diagnosis of metabolic syndrome according to NCEP ATP III definition. Metabolic syndrome was diagnosed in 1 (3.3%) of 30 patients above 10 years of age according to IDF definition and 20% of patients aged 6-10 years were considered to be risky for development of metabolic syndrome. Conclusion: It was found that the prevalence of metabolic syndrome was highest when NCEP ATP III definition was used.

Keywords:

metabolic syndrom congenital adrenal hyperplasia, 21-hydoxylase deficiency, childhood,

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