Table 1.
Centres screening for cardiometabolic comorbidity in adult patients with classic congenital adrenal hyperplasia and screening methods used
| Comorbidity | Screening for cardiometabolic comorbidity, n (%) | Frequency of screening, n (%) | ||||||
|---|---|---|---|---|---|---|---|---|
| Centres | Methods | Centres performing each method | Every visit | 6 monthly | 1 to 2 yearly | Othera | Not specified | |
| Hypertension | 30 (97) | Systolic and diastolic BP | 30 (100) | 1 (3) | 3 (10) | 9 (30) | 1 (3) | 16 (54) |
| 24-hour BP measurement | 6 (20) | – | – | – | 2 (33) | 4 (64) | ||
| Nocturnal BP measurement | – | – | – | – | – | – | ||
| Obesity | 30 (97) | BMI | 27 (90) | 2 (7) | 2 (7) | 8 (30) | – | 15 (56) |
| Weight | 25 (83) | 3 (12) | 1 (4) | 5 (20) | – | 16 (64) | ||
| Waist circumference | 9 (30) | – | 1 (11) | 3 (33) | – | 5 (56) | ||
| Hip circumference | 4 (13) | – | – | 1 (25) | – | 3 (75) | ||
| Abnormal glucose homoeostasis | 26 (84) | HbA1c | 19 (73) | 1 (5) | – | 8 (42) | 3 (16) | 7 (37) |
| Fasting plasma glucose | 13 (50) | – | – | 5 (38) | 2 (16) | 6 (46) | ||
| Random plasma glucose | 12 (46) | – | – | 7 (58) | – | 5 (42) | ||
| Fasting plasma insulin | 8 (31) | – | – | 3 (38) | 1 (12) | 4 (50) | ||
| HOMA index | 8 (31) | 1 (13) | – | 2 (25) | 2 (25) | 3 (37) | ||
| 2-hour blood glucose | 7 (27) | – | – | 1 (14) | 3 (43) | 3 (43) | ||
| Insulin resistance index | – | – | – | – | – | – | ||
| Hyperlipidaemia | 20 (65) | Fasting HDL cholesterol | 13 (65) | – | – | 5 (38) | – | 8 (62) |
| Fasting triglycerides | 13 (65) | – | – | 5 (38) | – | 8 (62) | ||
| Fasting total cholesterol | 12 (60) | – | – | 5 (42) | – | 7 (58) | ||
| Fasting LDL cholesterol | 11 (55) | – | – | 4 (36) | – | 7 (64) | ||
| Othersb | 6 (30) | – | – | – | – | 6 (100) | ||
| Cardiovascular disease | 6 (19) | Cardiac USS | 2 (33) | – | – | – | 1 (50) | 1 (50) |
| Stress test | – | – | – | – | – | – | ||
| Cardiac MRI | – | – | – | – | – | – | ||
| Othersb | 5 (83) | – | – | – | – | 5 (100) | ||
| Osteoporosis | 25 (81) | DEXA | 23 (92) | ≤5 yearly (4, 17%), >5 yearly (8, 35%) | 11 (48) | |||
| Othersb | 4 (16) | – | – | – | – | 4 (100) | ||
BP blood pressure, BMI body mass index, Hb1Ac haemoglobin 1Ac, HOMA homoeostatic model assessment of insulin resistance, HDL high density lipoprotein, LDL low density lipoprotein, USS ultrasound scan, MRI magnetic resonance imaging, DXA dual X-ray absorptiometry
aOther included only if problems identified (e.g. if random blood pressure (BP) reading elevated (n = 3), random hyperglycaemia (n = 7)) or screening every 2 years or less frequently (n = 5)
bOther screening methods: For hyperlipidaemia included non-fasting lipid profile (n = 4), lipid profile intermittently from age 40 (n = 1), unknown (n = 1); for cardiovascular disease included intima media thickness (IMT) USS evaluation (n = 2), history and clinical evaluation (n = 2), Electrocardiogram (n = 1); for osteoporosis included lumbar X-ray (n = 1), Q-risk fracture (n = 1), bone ultrasonography (n = 1), fracture score after 50’s (n = 1)