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Plasma dexamethasone levels in children given the dexamethasone suppression test
M W Naylor1, J F Greden, N E Alessi
1University of Michigan Department of Psychiatry, Child and Adolescent Psychiatric Hospital, Ann Arbor.
Biological Psychiatry
|March 15, 1990
Summary
Children with dexamethasone suppression test (DST) nonsuppression had lower plasma dexamethasone levels. Dosing dexamethasone by body surface area may improve DST accuracy in pediatric patients.
Area of Science:
- Pediatric endocrinology
- Neuroendocrinology
- Psychiatry
Background:
- The dexamethasone suppression test (DST) is used to assess hypothalamic-pituitary-adrenal (HPA) axis function.
- Evaluating DST results in children, particularly those with psychiatric disturbances, requires understanding factors influencing test outcomes.
Purpose of the Study:
- To investigate the relationship between plasma dexamethasone levels and DST results in children.
- To determine if lower plasma dexamethasone levels are associated with DST nonsuppression.
Main Methods:
- Administered the DST to 73 children aged 5-14 years.
- Measured plasma dexamethasone and postdexamethasone cortisol levels.
- Analyzed correlations between dexamethasone levels, cortisol levels, and DST suppression status.
Main Results:
- DST nonsuppressors exhibited significantly lower plasma dexamethasone levels compared to suppressors.
- Dexamethasone dosage (mg/m2) positively correlated with plasma dexamethasone and inversely with cortisol.
- A significant inverse correlation was found between plasma dexamethasone and postdexamethasone cortisol levels.
Conclusions:
- Plasma dexamethasone levels are crucial for interpreting DST results in psychiatrically disturbed children.
- Calculating dexamethasone dosage based on body surface area may enhance DST accuracy in pediatric populations.