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Background: Adolescents with classic congenital adrenal hyperplasia (CAH) show abnormal adrenal medulla dysfunction, and decreased adrenaline levels in neonates and infants
.
We know very little about the relationship between this and the incidence in the first year of life
.
Adolescents with classic congenital adrenal hyperplasia (CAH) show abnormal adrenal medulla dysfunction, and decreased adrenaline levels in neonates and infants
Methods: This prospective cohort study included participants recruited from pediatric tertiary care centers: 36 infants with classic CAH due to 21-hydroxylase deficiency and 27 age-matched congenital hypothyroidism Control group
.
The main observation indicators include plasma adrenaline level (N=27), CYP21A2 genotype (N=15) and the incidence of acute disease from birth to 1 year (N=28)
.
Results: The adrenaline level of CAH infants independently predicted the disease incidence in the first year of life (β = -0.
018, R = -0.
45, P = .
02), and was negatively correlated with 17-hydroxyprogesterone at diagnosis (R = -0.
51, P = 0.
007)
.
Compared with purely virilized infants, infants with salt-wasting CAH had lower levels of adrenaline in neonates (P = 0.
02)
Figure 1 Plasma epinephrine and 17-hydroxyprogesterone levels A of neonates with typical congenital adrenal hyperplasia caused by 21-hydroxylase deficiency.
At the time of diagnosis, neonatal epinephrine is negatively correlated with 17-OHP (N = 27, R =- 0.
51, P =0.
007)
.
B.
There is a negative correlation between neonatal adrenaline and the number of acute diseases in the first year of life (N = 28, R = -0.
Figure 1 Plasma epinephrine and 17-hydroxyprogesterone levels A of neonates with typical congenital adrenal hyperplasia caused by 21-hydroxylase deficiency.
Table 1 CYP21A2 genotypes, neonatal analytes, and congenital adrenal hyperplasia infant disease
Table 1 CYP21A2 genotypes, neonatal analytes, and congenital adrenal hyperplasia infant diseaseTable 2 The relative risk ratio of the incidence of congenital adrenal hyperplasia patients and the control group
Table 2 The relative risk ratio of the incidence of congenital adrenal hyperplasia patients and the control groupFigure 2 Plasma adrenaline levels in neonates and 1 year old patients with classic congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency.
In 11 children with CAH, plasma adrenaline was 84.
Figure 2 Plasma adrenaline levels in neonates and 1 year old patients with classic congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency.
Low adrenaline levels are associated with an increased risk of CAH infants
Weber J, Tanawattanacharoen VK, Seagroves A,,et al.
Low Adrenomedullary Function Predicts Acute Illness in Infants with Classical Congenital Adrenal Hyperplasia .
Low Adrenomedullary Function Predicts Acute Illness in Infants with Classical Congenital Adrenal Hyperplasia in this message