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Paediatric reference range for overnight urinary cortisol corrected for creatinine.

Ole D Wolthers1, Mark Lomax2, Anne Vibeke Schmedes3

  • 1Asthma and Allergy Clinic, Children's Clinic Randers, Randers, Denmark.

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This study establishes a mass spectrometry reference range for overnight urinary free cortisol corrected for creatinine (OUFCC) in children. These findings aid in assessing corticosteroid activity in pediatric patients.

Keywords:
childrencorticosteroidscortisolmass spectrometryreference datasteroids

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Area of Science:

  • Pediatric Endocrinology
  • Clinical Chemistry
  • Mass Spectrometry

Background:

  • Systemic effects of inhaled corticosteroids (ICS) can be monitored using urinary cortisol.
  • Overnight urinary free cortisol corrected for creatinine (OUFCC) is a validated marker in adults.
  • A pediatric reference range for OUFCC using mass spectrometry (MS) is currently lacking.

Purpose of the Study:

  • To establish a normative mass spectrometry (MS) reference range for overnight urinary free cortisol corrected for creatinine (OUFCC) in pre-pubertal children.
  • To provide a reliable method for assessing systemic corticosteroid activity in pediatric populations.
  • To facilitate the use of MS-based OUFCC assays in clinical practice.

Main Methods:

  • A cross-sectional study involving healthy pre-pubertal children aged 5 to 11 years.
  • Urine collection occurred overnight (10 pm or bedtime to 8 am).
  • Urinary free cortisol was quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS); creatinine was measured using a commercial assay.

Main Results:

  • Complete overnight urine collections were obtained from 142 children (72 males, 70 females).
  • The 95% prediction interval for OUFCC was 1.7-19.8 nmol/mmol.
  • The geometric mean OUFCC was 5.7 nmol/mmol, with a range of 1.1-24.8 nmol/mmol.

Conclusions:

  • Normative LC-MS/MS OUFCC reference data for children have been established.
  • These data support the use of MS-based OUFCC assays for evaluating corticosteroid activity in children.
  • This provides a crucial tool for assessing both endogenous and exogenous corticosteroid effects in pediatric patients.