{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:22:30Z","timestamp":1787678550107,"version":"build-2784847793"},"reference-count":51,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Sao Paulo Research Foundation","award":["2018\/10789-4"],"award-info":[{"award-number":["2018\/10789-4"]}]},{"name":"Sao Paulo Research Foundation","award":["1083\/2018"],"award-info":[{"award-number":["1083\/2018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Insulin sensitivity evaluation by hyperinsulinemic-euglycemic clamp in nonclassical congenital adrenal hyperplasia (NC-CAH) due to 21-hydroxilase deficiency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and Setting<\/jats:title>\n                  <jats:p>Cross-sectional study at university hospital outpatient clinics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and Methods<\/jats:title>\n                  <jats:p>NC-CAH patients (25 females, 6 males; 24 \u00b1 10 years) subdivided into C\/NC (compound heterozygous for 1 classical and 1 nonclassical allele) and NC\/NC (2 nonclassical alleles) genotypes were compared to controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At diagnosis, C\/NC patients presented higher basal and adrenocorticotropin-stimulated 17-hydroxyprogesterone and androstenedione levels than NC\/NC genotype. Patients and controls presented similar weight, body mass index, abdominal circumference, and total fat body mass. NC-CAH patients showed higher waist-to-hip ratio, lower adiponectin and lower high-density lipoprotein cholesterol levels with no changes in fasting plasma glucose, glycated hemoglobin, homeostatic model assessment for insulin resistance, leptin, interleukin 6, tumor necrosis factor alpha, C-reactive protein, and carotid-intima-media thickness. All patients had used glucocorticoid (mean time of 73 months). Among the 22 patients with successful clamp, 13 were still receiving glucocorticoid\u20143 patients using cortisone acetate, 9 dexamethasone, and 1 prednisone (hydrocortisone equivalent dose of 5.5mg\/m\u00b2\/day), while 9 patients were off glucocorticoid but had previously used (hydrocortisone equivalent dose of 5.9mg\/m2\/day). The NC-CAH patients presented lower Mffm than controls (31 \u00b1 20 vs 55 \u00b1 23\u00b5mol\/min-1\/kg-1, P = 0.002). The Mffm values were inversely correlated with the duration of glucocorticoid treatment (r = \u22120.44, P = 0.04). There was association of insulin resistance and glucocorticoid type but not with androgen levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Using the gold standard method, the hyperinsulinemic-euglycemic clamp, insulin resistance was present in NC-CAH patients and related to prolonged use and long-acting glucocorticoid treatment. Glucocorticoid replacement and cardiometabolic risks should be monitored regularly in NC-CAH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab767","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T10:44:25Z","timestamp":1635158665000},"page":"e1106-e1116","source":"Crossref","is-referenced-by-count":23,"title":["Hyperinsulinemic-Euglycemic Clamp Strengthens the Insulin Resistance in Nonclassical Congenital Adrenal Hyperplasia"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1275-7014","authenticated-orcid":false,"given":"Ariane","family":"Delai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-0991","authenticated-orcid":false,"given":"Patricia 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