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The hypothalamic-pituitary-adrenal axis in infantile malnutrition

S Malozowski1, S Muzzo, R Burrows

  • 1Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892.

Clinical Endocrinology
|April 1, 1990
PubMed

Insights

Severe childhood malnutrition disrupts the hypothalamic-pituitary-adrenal (HPA) axis. Nutritional rehabilitation restores normal HPA axis function and cortisol regulation.

Area of Science:

  • Endocrinology
  • Pediatrics
  • Nutritional Science

Background:

  • Childhood malnutrition, specifically marasmus, significantly impacts physiological systems.
  • The hypothalamic-pituitary-adrenal (HPA) axis plays a crucial role in stress response and metabolic regulation.

Purpose of the Study:

  • To investigate the circadian rhythm and HPA axis function in children with severe malnutrition.
  • To assess the effects of nutritional rehabilitation on HPA axis response to corticotrophin-releasing hormone (CRH) and dexamethasone suppression.

Main Methods:

  • Studied 32 children with grade II-III marasmus before and after nutritional rehabilitation.
  • Measured plasma cortisol levels in response to ovine corticotrophin-releasing hormone (oCRH) stimulation.
  • Evaluated dexamethasone suppression test to assess HPA axis feedback.

Main Results:

  • Elevated baseline plasma cortisol concentrations in malnourished children, which decreased significantly after rehabilitation.
  • Blunted cortisol response to oCRH stimulation in malnourished children, improving post-rehabilitation.
  • Incomplete dexamethasone suppression of cortisol in malnourished children, normalizing after nutritional rehabilitation.

Conclusions:

  • Malnutrition is associated with impaired HPA axis responsiveness and feedback mechanisms.
  • Nutritional rehabilitation effectively restores normal HPA axis function in children with marasmus.

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