CYP21A2 Genotypes do not Predict the Severity of Hyperandrogenic Manifestations in the Nonclassical Form of Congenital Adrenal Hyperplasia

Carregando...
Imagem de Miniatura
Citações na Scopus
17
Tipo de produção
article
Data de publicação
2013
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Citação
HORMONE AND METABOLIC RESEARCH, v.45, n.4, p.301-307, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
There is a strong correlation between the severity of genotypes and 17OH-progesterone levels in patients with the nonclassical form of 21-hydroxylase deficiency (NC-CAH); however, there are few studies regarding the correlation with clinical signs. The aim of the study was to evaluate whether genotypes correlate with the severity of the hyperandrogenic phenotype. A cohort of 114 NC-CAH patients were diagnosed by stimulated-17OHP >= 10 ng/ml. CYP21A2 genotypes were divided into 2 groups according to the severity of enzymatic impairment; mild and severe. Clinical data and hormonal profiles were compared between the 2 groups. Age at onset of manifestations did not differ between children or adults carrying both mild and severe genotypes. Frequencies of precocious pubarche and hirsutism, with or without menstrual abnormalities, were similar between the 2 groups. There were no differences in basal testosterone levels of adult symptomatic females carrying both genotypes, but there were differences between adult females with (92.9 +/- 49.5 ng/dl) and without hirsutism (43.8 +/- 38 ng/dl) (p=0.0002). Similar frequencies of both genotypes were observed in asymptomatic females and in those with clitoromegaly. Nonclassical genotypes do not predict the severity of phenotype. Asymptomatic and virilized females carrying the same genotype suggest that there is a modulatory effect of genes involved in the androgen pathway on the phenotype.
Palavras-chave
21-hydroxylase deficiency, genotype/phenotype correlation, hyperandrogenic manifestations, allelic distribution, nonclassical form
Referências
  1. Araujo RS, 2007, J CLIN ENDOCR METAB, V92, P4028, DOI 10.1210/jc.2006-2163
  2. AZZIZ R, 1989, J CLIN ENDOCR METAB, V69, P577
  3. Bachega TASS, 1998, J CLIN ENDOCR METAB, V83, P4416, DOI 10.1210/jc.83.12.4416
  4. Bachega TASS, 2000, CLIN ENDOCRINOL, V52, P601, DOI 10.1046/j.1365-2265.2000.00995.x
  5. Bachega TASS, 1999, HUM HERED, V49, P9, DOI 10.1159/000022833
  6. Bachega TASS, 2002, J CLIN ENDOCR METAB, V87, P786, DOI 10.1210/jc.87.2.786
  7. Bidet M, 2009, J CLIN ENDOCR METAB, V94, P1570, DOI 10.1210/jc.2008-1582
  8. Choi JH, 2012, EXP CLIN ENDOCR DIAB, V120, P23, DOI 10.1055/s-0031-1287789
  9. Costa-Barbosa FA, 2010, CLIN ENDOCRINOL, V73, P700, DOI 10.1111/j.1365-2265.2010.03871.x
  10. Deneux C, 2001, J CLIN ENDOCR METAB, V86, P207, DOI 10.1210/jc.86.1.207
  11. Doi SAR, 2006, STEROIDS, V71, P751, DOI 10.1016/j.steroids.2006.05.005
  12. Escobar-Morreale HF, 2008, J CLIN ENDOCR METAB, V93, P527, DOI 10.1210/jc.2007-2053
  13. Ezquieta B, 2002, ACTA PAEDIATR, V91, P892, DOI 10.1080/080352502760148595
  14. FERRIMAN D, 1961, J CLIN ENDOCR METAB, V21, P1440
  15. Gomes LG, 2009, J CLIN ENDOCR METAB, V94, P89, DOI 10.1210/jc.2008-1174
  16. Goodarzi MO, 2008, J CLIN ENDOCR METAB, V93, P2909, DOI 10.1210/jc.2008-0403
  17. Goodarzi MO, 2006, J CLIN ENDOCR METAB, V91, P4085, DOI 10.1210/jc.2006-0227
  18. HIGASHI Y, 1991, J BIOCHEM-TOKYO, V109, P638
  19. Kamrath C, 2012, J CLIN ENDOCR METAB, V97, pE367, DOI 10.1210/jc.2011-1997
  20. Krone N, 2000, J CLIN ENDOCR METAB, V85, P1059, DOI 10.1210/jc.85.3.1059
  21. L'Allemand D, 2000, J CLIN ENDOCR METAB, V85, P4562, DOI 10.1210/jc.85.12.4562
  22. Marino R, 2011, CLIN ENDOCRINOL, V75, P427, DOI 10.1111/j.1365-2265.2011.04123.x
  23. Martin KA, 2008, J CLIN ENDOCR METAB, V93, P1105, DOI 10.1210/jc.2007-2437
  24. Merke DP, 2005, LANCET, V365, P2125, DOI 10.1016/S0140-6736(05)66736-0
  25. Moran C, 2000, AM J OBSTET GYNECOL, V183, P1468, DOI 10.1067/mob.2000.108020
  26. Moran C, 2003, SEMIN REPROD MED, V21, P295
  27. New MI, 2004, ANN NY ACAD SCI, V1038, P14, DOI 10.1196/annals.1315.009
  28. Rocha RO, 2008, CLIN ENDOCRINOL, V68, P226, DOI 10.1111/j.1365-2265.2007.03023.x
  29. Silva EGP, 2003, HORM RES, V59, P229, DOI 10.1159/000070222
  30. SPEISER PW, 1988, NEW ENGL J MED, V319, P19, DOI 10.1056/NEJM198807073190104
  31. SPEISER PW, 1992, HUM GENET, V88, P647, DOI 10.1007/BF02265290
  32. Speiser PW, 2003, NEW ENGL J MED, V349, P776, DOI 10.1056/NEJMra021561
  33. Speiser PW, 2000, MOL GENET METAB, V71, P527, DOI 10.1006/mgme.2000.3036
  34. TUSIELUNA MT, 1990, J BIOL CHEM, V265, P20916
  35. Vottero A, 1999, J CLIN ENDOCR METAB, V84, P1091, DOI 10.1210/jc.84.3.1091
  36. WEDELL A, 1994, J CLIN ENDOCR METAB, V78, P1145, DOI 10.1210/jc.78.5.1145
  37. Weintrob N, 2000, EUR J ENDOCRINOL, V143, P397, DOI 10.1530/eje.0.1430397
  38. Wilson RC, 2007, MOL GENET METAB, V90, P414, DOI 10.1016/j.ymgme.2006.12.005