Adiposity rebound and height velocity in patients with Congenital Adrenal Hyperplasia.

Objective Adiposity rebound is the first rise in BMI that occurs after the initial decrease during infancy. Early adiposity rebound, before age 5, is a risk factor for later obesity and metabolic problems. We investigated adiposity rebound in children with Congenital Adrenal Hyperplasia due to 21-hydroxylase deficiency (CAH).Design Longitudinal observational registry study.Methods Height, weight and BMI from patients younger than 20 years in the I-CAH Registry was described by non-linear mixed-effects models. Covariates of glucocorticoid dose, mineralocorticoid dose, 17-Hydroxyprogesterone were assessed on growth and bone age.Results A total of 10,261 visits within 573 patients (43.6% male) showed significant variation in age at latest peak height velocity (8.4 years (SD = 3.0) in boys; 9.0 years (SD = 1.6) in girls). Peak height velocity was more blunted in boys (7.7 cm/year (SD = 1.4)) than girls (7.4 cm/year (SD = 1.3)) in comparison to normative values. Adiposity rebound occurred earlier than age 5 years in 82% of the cohort, mean age 3.7 years (SD = 1.3) in boys and 3.9 years (SD = 0.9) in girls. Girls prescribed higher doses of glucocorticoid were associated with heavier weight in adolescence and earlier adiposity rebound. Bone age was increasingly advanced in those prescribed higher doses in both sexes.Conclusions There is a large variation in the timing of adiposity rebound and SITAR-estimated latest peak height velocity in children with CAH. In addition to identifying individuals with CAH who may be at risk of adverse cardiometabolic outcomes these metrics may serve as early surrogate outcomes in future research investigating early-life treatment strategies.

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Publication Details

Journal
Open Access CRIS of the University of Bern
Published
2026-04-06
DOI
https://doi.org/10.48620/96815
Primary Topic
Sexual Differentiation and Disorders
Type
article
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article

Adiposity rebound and height velocity in patients with Congenital Adrenal Hyperplasia.

Rita Ortolano, Nils Krone, Walter Bonfig, Evgenia Globa et al.
Open Access CRIS of the University of Bern
Sexual Differentiation and Disorders
article

Adiposity rebound and height velocity in patients with Congenital Adrenal Hyperplasia.

Rita Ortolano, Nils Krone, Walter Bonfig, Evgenia Globa, Heba Elsedfy, Mirela Costa de Miranda, Ana Vieites, Uta Neumann, Niels Birkebæk, Alina German, Valérie Schwitzgebel Luscher, Savitha Shenoy, Christiaan de Bruin, Gabriella Gazdagh, Agustini Utari, Jeremy Dawson, Joseph Tonge, Federico Baronio, Evelien F. Gevers, Marianna Rita Stancampiano, Renata Markosyan, Nermine Hussein Amr, Minglu Chen, Malika Alimussina, Christa E Flueck, Ruth Krone, Sumudu Nimali Seneviratne, Inas Mazen, Jeremy Tomlinson, Irina Bacila, Margarett Shnorhavorian, Jillian Bryce, Salma Ali, Zi-Qiang Lang, Gianni Russo, Anuja Natarajan, Chamila Balagamage, Fathima Anverdeen, Nadia Amin, Ayla Güven, Gary S Collins, Rieko Tadokoro-Cuccaro, Alegria Ferri Perez, Cheryl Morris, Nina Lenherr-Taube, Tabitha Randell, Marek Niedziela, Mariacarolina Salerno, Şükran Poyrazoğlu, Harriet Miles, Magdalena Banaszak-Ziemska, Klaus L Mohnike, Violeta Iotova, Luisa De Sanctis, Martine Cools, Justin H Davies, Ursina Probst-Scheidegger, S. S. Zobaer Ahmed, Dominika Janus, Diego Yeste, Hetty J van der Kamp, Antony Fu, D Aled Rees, Neil R Lawrence, Sabine E Hannema, María Clemente-León, H El Kaddouri, Tânia Bachega, Otilia Marginean, Ajay Thankamony, Malgorzata Wasniewska
article en

Abstract

Objective Adiposity rebound is the first rise in BMI that occurs after the initial decrease during infancy. Early adiposity rebound, before age 5, is a risk factor for later obesity and metabolic problems. We investigated adiposity rebound in children with Congenital Adrenal Hyperplasia due to 21-hydroxylase deficiency (CAH).Design Longitudinal observational registry study.Methods Height, weight and BMI from patients younger than 20 years in the I-CAH Registry was described by non-linear mixed-effects models. Covariates of glucocorticoid dose, mineralocorticoid dose, 17-Hydroxyprogesterone were assessed on growth and bone age.Results A total of 10,261 visits within 573 patients (43.6% male) showed significant variation in age at latest peak height velocity (8.4 years (SD = 3.0) in boys; 9.0 years (SD = 1.6) in girls). Peak height velocity was more blunted in boys (7.7 cm/year (SD = 1.4)) than girls (7.4 cm/year (SD = 1.3)) in comparison to normative values. Adiposity rebound occurred earlier than age 5 years in 82% of the cohort, mean age 3.7 years (SD = 1.3) in boys and 3.9 years (SD = 0.9) in girls. Girls prescribed higher doses of glucocorticoid were associated with heavier weight in adolescence and earlier adiposity rebound. Bone age was increasingly advanced in those prescribed higher doses in both sexes.Conclusions There is a large variation in the timing of adiposity rebound and SITAR-estimated latest peak height velocity in children with CAH. In addition to identifying individuals with CAH who may be at risk of adverse cardiometabolic outcomes these metrics may serve as early surrogate outcomes in future research investigating early-life treatment strategies.

Open Access CRIS of the University of Bern
Good health and well-being
Openalex Percentile: Top 24%
Sexual Differentiation and Disorders
DOIOpen Access PDFOpenAlex
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