Size at birth and adrenocortical function in childhood

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P M Clark1, P C Hindmarsh, A W Shiell

  • 1MRC Environmental Epidemiology Unit, University of Southampton, UK.

Clinical Endocrinology
|December 1, 1996
PubMed

Insights

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.
Abstract

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