Evidence map›Paper›PMID 33677504›Full record

ArticleThe Journal of clinical endocrinology and metabolism2021

Cardiovascular Disease Risk Factors and Metabolic Morbidity in a Longitudinal Study of Congenital Adrenal Hyperplasia.

Ahmed Torky, Ninet Sinaii, Smita Jha, Jay Desai, Diala El-Maouche, Ashwini Mallappa, Deborah P Merke

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Approach to the Child and Adolescent With Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2025
    Review
  13. Review
  14. Review
  15. Review
  16. Review
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Ahmed TorkyThe Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0001-8036-5779
Ninet SinaiiBiostatistics and Clinical Epidemiology Service, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0003-4045-1386
Smita JhaNational Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0001-9201-3340
Jay DesaiNational Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Diala El-MaoucheNational Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0002-0936-2249
Ashwini MallappaNational Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0003-0637-4559
Deborah P MerkeThe Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0002-3746-0460
National Institutes of Health · USNational Institutes of Health Clinical Center · USGeorge Washington University · US

Funding

Natural History Study of Patients with Excess AndrogenZIAHD008934 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI MERKE, DEBORAH · 2013 to 2021
$238k
NIH HHS
6 · The paper itself

Abstract

contextPatients with congenital adrenal hyperplasia (CAH) are exposed to hyperandrogenism and supraphysiologic glucocorticoids, both of which can increase risk of metabolic morbidity.

objectiveOur aim was to evaluate cardiovascular and metabolic morbidity risk in a longitudinal study of patients with CAH spanning both childhood and adulthood. DESIGN AND

settingPatients with classic CAH followed for a minimum of 5 years during both childhood and adulthood (n = 57) at the National Institutes of Health were included and compared with the US general population using NHANES data.

main outcome measuresObesity, hypertension, insulin resistance, fasting hyperglycemia, and dyslipidemia.

resultsCompared to the US population, patients with CAH had higher (P < 0.001) prevalence of obesity, hypertension, insulin resistance, fasting hyperglycemia, and low high-density lipoprotein (HDL) during childhood and obesity (P = 0.024), hypertension (P<0.001), and insulin resistance (P < 0.001) during adulthood. In our cohort, obesity, hypertension, fasting hyperglycemia, and hypertriglyceridemia began prior to age 10. During childhood, increased mineralocorticoid dose was associated with hypertension (P = 0.0015) and low HDL (P = 0.0021). During adulthood, suppressed androstenedione was associated with hypertension (P = 0.002), and high low-density lipoprotein (P = 0.0039) whereas suppressed testosterone (P = 0.003) was associated with insulin resistance. Elevated 17-hydroxyprogesterone, possibly reflecting poor disease control, was protective against high cholesterol (P = 0.0049) in children. Children whose mothers were obese (maternal obesity) had increased risk of obesity during adulthood (P = 0.0021). Obesity, in turn, contributed to the development of hypertension, insulin resistance, and hypertriglyceridemia in adulthood.

conclusionPatients with CAH develop metabolic morbidity at a young age associated with treatment-related and familial factors. Judicious use of glucocorticoid and mineralocorticoid is warranted.

Indexed as

Insulin ResistanceAdolescentAdrenal Hyperplasia, CongenitalAdultCardiovascular DiseasesChildChild, PreschoolFemaleFollow-Up StudiesHumansHypertensionInfantInfant, NewbornLongitudinal StudiesMaleMetabolic Syndromeandrogencongenital adrenal hyperplasiaglucocorticoidmetabolic syndromemineralocorticoid

Identifiers

PMID33677504
PMCPMC8864751
OpenAlexW3135669614

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.