Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia

ContextCardiometabolic complications are increasingly recognized in congenital adrenal hyperplasia (CAH) due to 21β-hydroxylase deficiency, but adult data remain limited.ObjectiveTo evaluate cardiovascular and metabolic alterations in adult patients with classic CAH under glucocorticoid treatment, c...

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Main Authors: Lorenzo Campioni, Maria Chiara Di Carlo, Chiara Sola, Beatrice Bergoglio, Martina Bollati, Giulia Montesano, Federico Ponzetto, Chiara Lopez, Giovanna Motta, Mirko Parasiliti-Caprino, Roberta Giordano
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1660114/full
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author Lorenzo Campioni
Lorenzo Campioni
Maria Chiara Di Carlo
Maria Chiara Di Carlo
Chiara Sola
Chiara Sola
Beatrice Bergoglio
Beatrice Bergoglio
Martina Bollati
Martina Bollati
Giulia Montesano
Federico Ponzetto
Federico Ponzetto
Chiara Lopez
Chiara Lopez
Giovanna Motta
Giovanna Motta
Mirko Parasiliti-Caprino
Mirko Parasiliti-Caprino
Roberta Giordano
Roberta Giordano
author_facet Lorenzo Campioni
Lorenzo Campioni
Maria Chiara Di Carlo
Maria Chiara Di Carlo
Chiara Sola
Chiara Sola
Beatrice Bergoglio
Beatrice Bergoglio
Martina Bollati
Martina Bollati
Giulia Montesano
Federico Ponzetto
Federico Ponzetto
Chiara Lopez
Chiara Lopez
Giovanna Motta
Giovanna Motta
Mirko Parasiliti-Caprino
Mirko Parasiliti-Caprino
Roberta Giordano
Roberta Giordano
author_sort Lorenzo Campioni
collection DOAJ
description ContextCardiometabolic complications are increasingly recognized in congenital adrenal hyperplasia (CAH) due to 21β-hydroxylase deficiency, but adult data remain limited.ObjectiveTo evaluate cardiovascular and metabolic alterations in adult patients with classic CAH under glucocorticoid treatment, compared to matched controls.MethodsA cross-sectional study was conducted on adults with classic CAH and sex- and BMI-matched controls. Cardiovascular and metabolic variables and parameters were collected in all patients.ResultsThe study enrolled 32 CAH patients and 73 controls. In univariate analyses, CAH patients showed significantly shorter QTc intervals (p=0.004), longer QRS duration and shorter RR intervals, in comparison with controls. Even in presence of a more favorable hypertensive (lower diastolic blood pressure and higher heart rate variability) and metabolic profile (lower fasting glucose, LDL cholesterol, triglycerides, and higher HDL), CAH patients had higher Ambulatory Arterial Stiffness Index (AASI) (p=0.006). Multivariate regression confirmed the association between CAH and both increased AASI (EC 1.131, p<0.001) and shortened QTc (EC 0.977, p=0.039), adjusting for all potential confounders. Within the CAH group, 17-hydroxyprogesterone was positively associated with AASI (EC 1.001, p=0.049), while ACTH (EC 0.999, p=0.021) was inversely associated with QTc, after correction for all clinical confounders. Propensity score-matched analysis with 1:2 matching ratio, based on the same regression models, confirmed that CAH diagnosis was associated with AASI (p<0.001) and QTc (p=0.004).ConclusionsAdults with classic CAH show increased arterial stiffness and altered cardiac repolarization, likely linked to chronic hormonal imbalance. These findings underscore the need for cardiovascular monitoring in long-term CAH management.
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spelling doaj-art-fb1e1a3567f9462d8bbb4c740f873f402025-08-22T04:10:32ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.16601141660114Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasiaLorenzo Campioni0Lorenzo Campioni1Maria Chiara Di Carlo2Maria Chiara Di Carlo3Chiara Sola4Chiara Sola5Beatrice Bergoglio6Beatrice Bergoglio7Martina Bollati8Martina Bollati9Giulia Montesano10Federico Ponzetto11Federico Ponzetto12Chiara Lopez13Chiara Lopez14Giovanna Motta15Giovanna Motta16Mirko Parasiliti-Caprino17Mirko Parasiliti-Caprino18Roberta Giordano19Roberta Giordano20Endocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyClinical Biochemistry Laboratory, City of Health and Science University Hospital, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyDepartment of Medical Sciences, University of Turin, Turin, ItalyDepartment of Biological and Clinical Sciences, University of Turin, Turin, ItalyContextCardiometabolic complications are increasingly recognized in congenital adrenal hyperplasia (CAH) due to 21β-hydroxylase deficiency, but adult data remain limited.ObjectiveTo evaluate cardiovascular and metabolic alterations in adult patients with classic CAH under glucocorticoid treatment, compared to matched controls.MethodsA cross-sectional study was conducted on adults with classic CAH and sex- and BMI-matched controls. Cardiovascular and metabolic variables and parameters were collected in all patients.ResultsThe study enrolled 32 CAH patients and 73 controls. In univariate analyses, CAH patients showed significantly shorter QTc intervals (p=0.004), longer QRS duration and shorter RR intervals, in comparison with controls. Even in presence of a more favorable hypertensive (lower diastolic blood pressure and higher heart rate variability) and metabolic profile (lower fasting glucose, LDL cholesterol, triglycerides, and higher HDL), CAH patients had higher Ambulatory Arterial Stiffness Index (AASI) (p=0.006). Multivariate regression confirmed the association between CAH and both increased AASI (EC 1.131, p<0.001) and shortened QTc (EC 0.977, p=0.039), adjusting for all potential confounders. Within the CAH group, 17-hydroxyprogesterone was positively associated with AASI (EC 1.001, p=0.049), while ACTH (EC 0.999, p=0.021) was inversely associated with QTc, after correction for all clinical confounders. Propensity score-matched analysis with 1:2 matching ratio, based on the same regression models, confirmed that CAH diagnosis was associated with AASI (p<0.001) and QTc (p=0.004).ConclusionsAdults with classic CAH show increased arterial stiffness and altered cardiac repolarization, likely linked to chronic hormonal imbalance. These findings underscore the need for cardiovascular monitoring in long-term CAH management.https://www.frontiersin.org/articles/10.3389/fendo.2025.1660114/fullcardiovascular riskcongenital adrenal hyperplasia21-hydroxylase deficiencyarterial stiffnessandrogensACTH
spellingShingle Lorenzo Campioni
Lorenzo Campioni
Maria Chiara Di Carlo
Maria Chiara Di Carlo
Chiara Sola
Chiara Sola
Beatrice Bergoglio
Beatrice Bergoglio
Martina Bollati
Martina Bollati
Giulia Montesano
Federico Ponzetto
Federico Ponzetto
Chiara Lopez
Chiara Lopez
Giovanna Motta
Giovanna Motta
Mirko Parasiliti-Caprino
Mirko Parasiliti-Caprino
Roberta Giordano
Roberta Giordano
Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
Frontiers in Endocrinology
cardiovascular risk
congenital adrenal hyperplasia
21-hydroxylase deficiency
arterial stiffness
androgens
ACTH
title Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
title_full Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
title_fullStr Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
title_full_unstemmed Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
title_short Arterial stiffness and shortened QTc interval are associated with androgen and ACTH levels in classic congenital adrenal hyperplasia
title_sort arterial stiffness and shortened qtc interval are associated with androgen and acth levels in classic congenital adrenal hyperplasia
topic cardiovascular risk
congenital adrenal hyperplasia
21-hydroxylase deficiency
arterial stiffness
androgens
ACTH
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1660114/full
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