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Cortisol and growth hormone responses to spontaneous hypoglycaemia in infants and children

P M Crofton1, P C Midgley

  • 1Department of Paediatric Biochemistry, Royal Hospital for Sick Children, Edinburgh, UK. patricia.crofton@luht.scot.nhs.uk

Archives of Disease in Childhood
|April 23, 2004
PubMed

Insights

Infants and children show age-dependent responses to hypoglycemia. Young infants have a weaker cortisol response, while older children may have similar glucose thresholds for cortisol and growth hormone (GH) secretion as adults.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Hormonal Regulation

Background:

  • Hypoglycemia, or low blood glucose, is a common metabolic disturbance in infants and children.
  • Understanding the hormonal responses to hypoglycemia is crucial for diagnosis and management.
  • Cortisol and growth hormone (GH) are key counter-regulatory hormones involved in glucose homeostasis.

Purpose of the Study:

  • To investigate the age-specific responses of cortisol and growth hormone (GH) to spontaneous hypoglycemia in pediatric patients.
  • To compare hormonal responses between hypoglycemic and non-hypoglycemic children of different age groups.
  • To determine if glycaemic thresholds for hormonal secretion in older children resemble those in adults.

Main Methods:

  • Retrospective analysis of laboratory and clinical data from pediatric patients investigated for hypoglycemia over five years.
  • Inclusion of 30 patients with confirmed hypoglycemia (glucose <2.5 mmol/l) and 26 controls (glucose ≥2.5 mmol/l).
  • Stratification of patients into age groups: <3 months and >6 months.

Main Results:

  • Common causes of hypoglycemia included transient hyperinsulinism in infants <3 months and infection in children >6 months.
  • Cortisol levels correlated positively with age, while GH levels correlated inversely with age in both groups.
  • Infants <3 months had significantly lower median cortisol and higher median GH concentrations compared to children >6 months, irrespective of glucose levels.

Conclusions:

  • Hormonal responses to hypoglycemia, specifically cortisol and GH, are significantly influenced by age in children.
  • Young infants (<3 months) exhibit a blunted cortisol response to hypoglycemia compared to older children.
  • Children over 6 months may possess glycaemic thresholds for cortisol and GH secretion comparable to adult levels.
Abstract

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