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Size at birth and adrenocortical function in childhood
P M Clark1, P C Hindmarsh, A W Shiell
1MRC Environmental Epidemiology Unit, University of Southampton, UK.
Clinical Endocrinology
|December 1, 1996
Summary
Fetal size at birth impacts adult health. Lower birth weight is linked to higher adrenal androgen metabolite excretion in children, suggesting lasting effects of the intra-uterine environment on the hypothalamo-pituitary-adrenal axis.
Area of Science:
- Endocrinology
- Developmental Biology
- Public Health
Background:
- Reduced size at birth is associated with increased risk of cardiovascular disease and non-insulin-dependent diabetes mellitus in adulthood.
- The intra-uterine environment may permanently alter hypothalamo-pituitary-adrenal (HPA) axis function, mediating this association.
Purpose of the Study:
- To investigate the relationship between size at birth and the function of the HPA axis in childhood.
- To assess urinary excretion of adrenal androgen and glucocorticoid metabolites in relation to birth weight.
Main Methods:
- 190 children (9-year-olds) provided 24-hour urine samples.
- Urinary breakdown products of dehydroepiandrosterone sulfate (adrenal androgen metabolites) and cortisol/cortisone (glucocorticoid metabolites) were measured.
- Gas chromatography was used to quantify metabolite excretion in microgram/day.
Main Results:
- Higher urinary adrenal androgen metabolite excretion was observed in children with lower birth weights (40% increase per 1-kg decrease).
- This association was independent of current weight, age, and sex.
- Glucocorticoid metabolite excretion showed a U-shaped relationship with birth weight, being highest in children who were light or heavy at birth, persisting after adjustments.
Conclusions:
- Fetal size at birth, a proxy for the intra-uterine environment, has enduring effects on HPA axis function.
- These findings provide insights into the developmental origins of adult disease risk.