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Responsiveness of cortisol and dehydroepiandrosterone to ACTH in children
Insights
Adrenal androgen dehydroepiandrosterone (DHA) regulation in children involves adrenocorticotropic hormone (ACTH) and other hormones. DHA responsiveness peaks during adrenarche, indicating a complex developmental interplay.
Area of Science:
- Pediatric Endocrinology
- Adrenal Physiology
- Hormonal Regulation
Background:
- Dehydroepiandrosterone (DHA) and cortisol (F) are key adrenal steroids.
- Understanding their regulation is crucial for pediatric endocrine health.
- Adrenarche signifies a developmental shift in adrenal androgen production.
Purpose of the Study:
- To investigate the regulation of dehydroepiandrosterone (DHA) and cortisol (F) in children.
- To assess the impact of adrenocorticotropic hormone (ACTH) on DHA and F levels during development.
- To explore hormonal influences on adrenal androgen production in various pediatric conditions.
Main Methods:
- Measurement of dehydroepiandrosterone (DHA) and cortisol (F) levels in 101 children.
- Administration of ACTH (Synacten) to assess hormonal responsiveness.
- Comparison of responses in healthy children, hypopituitary patients, Turner's syndrome, and hypergonadotrophic males.
Main Results:
- Cortisol (F) responsiveness remained consistent across development.
- Dehydroepiandrosterone (DHA) responsiveness was highest during adrenarche in healthy children.
- Hypopituitary patients showed lower DHA levels, but similar ACTH responsiveness patterns.
- Elevated DHA levels and ACTH-induced DHA responses were observed in specific genetic conditions.
Conclusions:
- Adrenal androgen regulation involves both ACTH and a separate hypothalamo-pituitary hormone.
- This regulation appears independent of gonadal activation but requires gonadal integrity.
- Developmental changes in DHA responsiveness are significant, particularly during adrenarche.
Abstract:
In a total of 101 children, the dehydroepiandrosterone (DHA) and cortisol (F) levels were measured before and after ACTH (Synacten) administration. F responsiveness was unchanged during development, while DHA responsiveness in healthy children was highest during adrenarche. In hypopituitary patients DHA levels were lower than in the controls, but responsiveness to ACTH showed similar changes during development. Children with Turner's syndrome and hypergonadotrophic males had the response in elevated DHA levels while ACTH-induced DHA response related to bone-age matched controls. We conclude that regulation of adrenal androgens is mediated by both ACTH and another hypothalamo-pituitary hormone, perhaps independent of gonadal activation, but requiring gonadal integrity.