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Adrenal steroid hormones in short children born small for gestational age
J Dahlgren1, M Boguszewski, S Rosberg
1Department of Paediatrics, University of Göteborg, Sweden. Jovanna.Dahlgren@Pediat.gu.se
Insights
Fetal growth impacts adrenal hormones. While cortisol levels are similar in children born small for gestational age (SGA) and appropriate for gestational age (AGA), dehydroepiandrosterone sulphate (DHEAS) levels correlate with birth weight before adrenarche.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Fetal Development
Background:
- Endocrine axis programming during fetal development is sensitive to intrauterine growth.
- Intrauterine growth retardation may impact adrenal steroid hormone production.
- Adrenal steroid hormones play crucial roles in child development and growth.
Purpose of the Study:
- To investigate the relationship between fetal growth and adrenal steroid hormone programming.
- To compare serum cortisol and dehydroepiandrosterone sulphate (DHEAS) levels in children born small for gestational age (SGA) versus appropriate for gestational age (AGA).
- To assess if these hormone levels correlate with birth size in prepubertal children.
Main Methods:
- Measured serum cortisol over 24 hours and dehydroepiandrosterone sulphate (DHEAS) in 184 prepubertal children.
- Included groups: short children born SGA, short children born AGA, and normal height children born AGA.
- Utilized radioimmunoassay for hormone measurements.
Main Results:
- No significant differences in cortisol levels (area under the curve) or circadian rhythm between SGA and AGA groups.
- Serum DHEAS concentrations were similar across all groups.
- Serum DHEAS, but not cortisol, showed an inverse correlation with birth weight when adjusted for age.
Conclusions:
- Serum cortisol levels and rhythms are not associated with birth size in children.
- Dehydroepiandrosterone sulphate (DHEAS) levels in prepubertal children correlate inversely with birth weight, suggesting a link to fetal growth.
- These findings highlight a potential programming effect of fetal growth on specific adrenal steroid hormones.
Objective:
Programming of the endocrine axis has been postulated to occur during critical phases of fetal development and is affected by intrauterine growth retardation. The aim of this study was to investigate this hypothesis with regard to adrenal steroid hormones. Thus, serum cortisol and dehydroepiandrosterone sulphate (DHEAS) levels were compared in children born small for gestational age (SGA) who remained short and in children born at an appropriate size for gestational age (AGA), of both short and normal stature.
Design And Patients:
Seven serum samples for cortisol measurements were taken during a 24-h period from a total of 184 prepubertal individuals. The study group comprised 53 children born SGA who remained short (41 boys, 12 girls; mean chronological age, 8.8 +/- 2.5 years). The reference groups of children born AGA were as follows: 75 healthy short children (56 boys, 19 girls; mean chronological age, 10.8 +/- 2.6 years) and 56 healthy children of normal height (37 boys, 19 girls; mean chronological age, 11.3 +/- 1.8 years). A single serum sample for measurement of DHEAS was taken between 1000 and 1400 h in 110 of the 184 children (33 short SGA, 42 short AGA and 35 AGA of normal height).
Measurements:
Serum cortisol and DHEAS were measured by radioimmunoassay.
Results:
No differences were found between children born SGA and children born AGA in either cortisol levels, calculated as area under the curve (AUC), or the circadian cortisol rhythm, estimated from the calculated nadir, the peak and the amplitude. No difference between the groups was found for serum DHEAS concentrations. Serum cortisol levels, expressed as AUC, and serum DHEAS levels did not correlate with size at birth. However, when adjusted for age at investigation, serum DHEAS, but not serum cortisol, correlated with weight at birth.
Conclusions:
Serum cortisol levels and rhythms do not correlate with size at birth and are similar in children born small for gestational age who remain short and children born appropriate size for gestational age of both short and normal stature. However, DHEAS levels in young children before adrenarche correlated inversely with weight at birth, indicating a relationship with fetal growth.