# Growth Assessment and Nutritional Status in Children with Congenital Adrenal Hyperplasia—A Cross-Sectional Study from a Vietnamese Tertiary Pediatric Center

## TL;DR

This study finds that many children with congenital adrenal hyperplasia in Vietnam face growth issues, obesity, and vitamin D deficiencies despite treatment.

## Contribution

The study provides insights into growth and nutritional challenges in Vietnamese children with CAH, highlighting risk factors and management needs.

## Key findings

- Stunting was observed in 16.4% of children, while 53.3% were overweight or obese.
- Vitamin D insufficiency or deficiency was detected in 85.6% of patients.
- Bone age advancement occurred in 51.7% of cases, linked to older age and prolonged corticosteroid therapy.

## Abstract

Background/Objectives: Children with congenital adrenal hyperplasia (CAH) face significant risks of impaired growth and metabolic disturbances despite standard glucocorticoid therapy. This cross-sectional study aimed to evaluate growth outcomes, nutritional status, and associated factors among children with CAH treated in a Vietnamese tertiary pediatric center. Methods: We assessed 201 children aged 1.1–16.5 years in a tertiary pediatric center in Vietnam for anthropometric parameters, biochemical markers (calcium, phosphate, 25-hydroxyvitamin D), and clinical features. Growth status was evaluated using WHO standards, and bone age was assessed radiographically. Statistical analyses explored associations between growth outcomes and clinical, biochemical, and treatment-related factors. Results: Stunting was present in 16.4% of children, while 53.3% were overweight or obese. Bone age advancement occurred in 51.7% of cases. Vitamin D insufficiency or deficiency was detected in 85.6% of patients, and hypocalcemia was present in 85.1%. Overweight/obesity, vitamin D deficiency, and bone age advancement were associated with older age, prolonged corticosteroid therapy, higher androgen levels, and clinical features of treatment imbalance (e.g., Cushingoid appearance, hyperpigmentation). Female sex was significantly associated with higher rates of stunting. Conclusions: Growth impairment, nutritional deficiencies, and skeletal maturation disturbances are prevalent among children with CAH in Vietnam. Early identification of risk factors and the implementation of tailored management strategies that address both endocrine and nutritional health are crucial for optimizing long-term outcomes.