Evaluation of body composition in children and adolescents with classical and non-classical congenital adrenal hyperplasia due to 21 hydroxylase deficiency

Aim: In this cross-sectional study, we aimed to evaluate muscle mass, fat, fluid, and mineral amounts measured by a body composition device in children and adolescents diagnosed with congenital adrenal hyperplasia, together with the patients' simultaneously measured serum adrenal steroid levels and the steroid doses they were using, and to compare their body composition with that of a healthy control group. Materials and Methods: Nineteen cases aged 0–18 years diagnosed with congenital adrenal hyperplasia and followed by the Division of Pediatric Endocrinology, Department of Pediatrics, Istanbul University–Cerrahpaşa, Cerrahpaşa Faculty of Medicine, were included in the study. Twenty age and sex matched subjects were designated as the control group. Anthropometric measurements were performed for all participants. Concurrently, body composition was measured using a Tanita bioelectrical impedance device together with adrenal steroid measurements, and the steroid treatment doses received by the cases were recorded. Body composition measurement was also performed for the control group. Results: The body composition (fat, muscle, bone mineral content, and body fluid) of 19 children/adolescents with classic CAH due to 21-hydroxylase deficiency and 20 age-matched healthy controls did not differ. In the CAH group, DHEAS and androstenedione levels showed significant positive correlations with height, body weight, muscle mass, bone mineral, and fluid mass; insulin levels showed significant positive correlations particularly with fat and fluid mass. No marked relationship was observed between steroid doses and body composition parameters. Conclusion: These findings indicate that our patients with congenital adrenal hyperplasia (CAH) do not differ from healthy controls in terms of body composition, and that adrenal steroids are directly associated with muscle mass, fluid mass, and mineral content. Keywords: Congenital Adrenal Hyperplasia, 21-Hydroxylase deficiency, body composition