We aimed to compare detailed fat distribution and lipid profile between young adults with congenital adrenal hyperplasia due to 21‐hydroxylase enzyme deficiency and a control group. We also verified independent associations of treatment duration and daily hydrocortisone dose equivalent (HDE) with lipid profile within patients. This case–control study included 23 patients (7 male and 16 female) matched by an age range of young adults (18–31 years) with 20 control subjects (8 male and 12 female). Dual energy X‐ray absorptiometry was used to measure the fat distribution. Male patients demonstrated elevated indices of fat mass for total (7.7 ± 2.1 vs. 4.5 ± 1.3 kg/m², p = 0.003), trunk (4.0 ± 1.2 vs. 2.2 ± 0.8 kg/m², p = 0.005), android (0.63 ± 0.24 vs. 0.32 ± 0.15 kg/m², p = 0.008), gynoid (1.34 ± 0.43 vs. 0.74 ± 0.24 kg/m², p = 0.005), arm (0.65 ± 0.16 vs. 0.39 ± 0.10 kg/m², p = 0.009), and leg regions (2.7 ± 0.8 vs. 1.6 ± 0.4 kg/m², p = 0.005) than the control group, but not in females. However, female patients demonstrated elevated ratio of low‐density lipoprotein cholesterol to high‐density lipoprotein cholesterol (1.90 ± 0.46 vs. 1.39 ± 0.47, p = 0.009) than the control group, but not in males. Total fat mass was inversely correlated with total testosterone (r = −0.64, p = 0.014) and positively correlated with leptin in males (r = 0.75, p = 0.002). An elevated daily HDE (β = 0.43, p = 0.038 and β = 0.47, p = 0.033) and trunk to total fat mass ratio (β = 0.46, p = 0.025, and β = 0.45, p = 0.037) were independently correlated with impaired lipid profile markers. Although there is no altered lipid profile, male patients demonstrated an increased fat distribution. However, female patients presented with an impaired lipid profile marker but demonstrated close values of normal fat distribution. Interestingly, the dose of glucocorticoid therapy can have some role in the lipid mechanisms.

中文翻译：

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因 21-羟化酶缺乏而患有先天性肾上腺增生的年轻人的脂肪分布和脂质分布。

我们的目的是比较因 21-羟化酶缺乏导致的先天性肾上腺增生的年轻成人和对照组之间的详细脂肪分布和脂质分布。我们还验证了治疗持续时间和每日氢化可的松剂量当量 (HDE) 与患者血脂的独立关联。该病例对照研究包括 23 名患者（7 名男性和 16 名女性）与 20 名对照受试者（8 名男性和 12 名女性）的年龄范围相匹配的年轻成人（18-31 岁）。双能X射线吸收法用于测量脂肪分布。男性患者的总脂肪量指数升高（7.7 ± 2.1 vs. 4.5 ± 1.3 kg/m ²，p = 0.003），躯干（4.0 ± 1.2 vs. 2.2 ± 0.8 kg/m ², p = 0.005), 机器人 (0.63 ± 0.24 vs. 0.32 ± 0.15 kg/m ² , p = 0.008), gynoid (1.34 ± 0.43 vs. 0.74 ± 0.24 kg/m ² , p ), 5 ± 0.065 0.16 vs. 0.39 ± 0.10 kg/m ² , p = 0.009) 和腿部区域 (2.7 ± 0.8 vs. 1.6 ± 0.4 kg/m ² , p = 0.005) 与对照组相比，但不是女性。然而，女性患者的低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比率升高（1.90 ± 0.46 vs. 1.39 ± 0.47，p= 0.009) 比对照组，但不是在男性。总脂肪量与总睾酮呈负相关 ( r = -0.64, p = 0.014)，与男性瘦素呈正相关 ( r = 0.75, p = 0.002)。每日 HDE 升高（β = 0.43，p = 0.038 和β = 0.47，p = 0.033）和躯干与总脂肪质量比（β = 0.46，p = 0.025，β = 0.45，p= 0.037) 与受损的脂质特征标志物独立相关。虽然没有改变脂质分布，但男性患者表现出脂肪分布增加。然而，女性患者的脂质特征标志物受损，但表现出接近正常脂肪分布的值。有趣的是，糖皮质激素治疗的剂量在脂质机制中可能有一些作用。