Reproductive Endocrinology

SAT-158 - Steatotic Liver Disease, Metabolic Profile, and Quality of Life in Adults with Congenital Adrenal Hyperplasia and Polycystic Ovary Syndrome

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Location: ENDOExpo; Poster Floor

Co-Author(s)

AG

Alvaro MP Gomes, Medical Student

Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil
SN

Savio L S Neves, MD

Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil

Abstract Poster Presenter(s)

FL

Felipe AA Leao, MD (he/him/his)

Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Minas Gerais, Brazil

Co-Author(s)

MP

Marcela O. Paiva, Medical Student

Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil
MA

Mariana G. Almeida, MD

Medical student
Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil
DT

Daniela OL Taranto, MD (she/her/hers)

Hospital das Clinicas da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil
LF

Luciana C. Faria, MD, PhD (she/her/hers)

Faculdade de Medicina da Universidade Federal de Minas Gerais
Belo Horizonte, Brazil

Senior Author/Primary Investigator(s)

Leticia FG Silveira, MD, PhD (she/her/hers)

Professor
Universidade Federal de Minas Gerais
Belo Horizonte, Brazil

Background: Congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH-21OH) is characterized by variable adrenal insufficiency and hyperandrogenism. Chronic exposure to glucocorticoid therapy and androgen excess may increase cardiometabolic risk. Metabolic dysfunction–associated steatotic liver disease (MASLD) is closely linked to insulin resistance, dyslipidemia, and central obesity, and disease burden may negatively impact quality of life (QoL).

Objectives: To evaluate the prevalence of MASLD in adults with classic CAH-21OH and to assess metabolic comorbidities and QoL compared with women with polycystic ovary syndrome (PCOS) and controls.

Methods: This observational cross-sectional prospective study included 142 adults from a tertiary referral center: 43 with CAH-21OH, 53 women with PCOS, and 46 women recruited from the Gynecology outpatient clinic as controls. Participants underwent clinical and laboratory assessment, abdominal ultrasound, and transient elastography. Metabolic and hepatic indices (TyG, VAI, LAP, FIB-4, APRI) were calculated. QoL was evaluated using the WHOQOL-BREF questionnaire.

Results: Mean age was similar across groups (33 years). Most CAH patients (88.4%) were receiving glucocorticoids, predominantly dexamethasone (mean dose 0.35 mg; hydrocortisone-equivalent 12 mg/day), and 44.2% used fludrocortisone. MASLD prevalence was 23.5% in CAH patients, with no significant difference compared with PCOS and controls. Women with PCOS had higher body weight, BMI, and waist circumference (p < 0.05). Hypertension was more frequent in PCOS (30.2%) than in CAH (2.3%) and controls (4.3%; p< 0.05). Prediabetes was more prevalent in CAH and PCOS than in controls (16.3% and 43.4% vs. 2.2%; p< 0.05), while type 2 diabetes rates were similar. Liver enzymes and metabolic parameters were largely comparable, although ALT levels were slightly higher in CAH than PCOS (p < 0.05). CAH patients showed lower VAI and LAP indices than PCOS patients (p < 0.05). QoL scores were higher in CAH compared with PCOS across all domains and higher than controls in the environmental domain.

Conclusions: MASLD prevalence was similar among adults with CAH-21OH, PCOS, and controls. CAH patients demonstrated a more favorable visceral adiposity profile and better QoL. Despite predominant dexamethasone use, CAH patients did not exhibit worse metabolic or hepatic outcomes, suggesting that, under specialized follow-up, dexamethasone therapy may not inevitably lead to adverse metabolic consequences.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*