Cortisol production rate in childhood and adolescence

Linder, Barbara; Esteban, Nora V.; Yergey, Alfred L.; Winterer, Jorg; Loriaux, D. Lynn; Cassorla, Fernando

doi:10.1016/s0022-3476(05)80128-3

Cited by 183 publications

(87 citation statements)

References 15 publications

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“…A -A -u* /< Λ\ ΤΛ 3 ) to test * or significant differences in serum eortisol and a marked decrease towards midnight (1)(2)(3)(4). De-' .…”

Section: A λ a A -4mentioning

confidence: 99%

Establishment of Reference Ranges for Cortisol in Neonates, Infants, Children and Adolescents

Jonetz-Mentzel¹,

Wiedemann²

1993

Clinical Chemistry and Laboratory Medicine

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Summary:Cortisol was determined in the sera of 687 normal, healthy probands between the ages of 5 days and 18 years (neonates, infants, children and adolescents), using a fluorescence polarization immunoassay (FPIA) on the TDx from Abbott Laboratories. The proband collective was divided into 9 age groups and each group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. Only a few reference groups showed a normal Gaussian distribution. In addition to the 50th percentile, the 2.5th and 97.5th percentiles were determined for all reference groups. Minimal and maximal values were also determined. The U-test of Mann & Whitney was used to test for significant differences between the individual reference groups. Groups showing no significant differences were combined, and reference ranges were finally calculated for eortisol in the serum of normal, healthy neonates, infants, children and adolescents. The serum eortisol concentration showed a significant increase with age. In the 14 -15 years age group, there was also a significant difference between males and females. IntroductionThe aim of the investigation was:

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“…A -A -u* /< Λ\ ΤΛ 3 ) to test * or significant differences in serum eortisol and a marked decrease towards midnight (1)(2)(3)(4). De-' .…”

Section: A λ a A -4mentioning

confidence: 99%

Establishment of Reference Ranges for Cortisol in Neonates, Infants, Children and Adolescents

Jonetz-Mentzel¹,

Wiedemann²

1993

Clinical Chemistry and Laboratory Medicine

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“…Importantly, relatively few studies deal with the Height, weight, and body mass index values of the subjects diurnal variation of cortisol levels in children, developmental were all within the third to 97th percentile range (26). A total and physiologic aspects of function in young age, and of 178 healthy subjects were recruited from an inner city influ' ' ' ' of and pubertal On neighborhood (Munich, Germany), the local kindergarden, and cortisol levels (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). W e have mcasured cortisol levels in local schools to participate in the study.…”

mentioning

confidence: 99%

Salivary Cortisol Levels throughout Childhood and Adolescence: Relation with Age, Pubertal Stage, and Weight

et al. 1995

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The measurement of cortisol in saliva has become a reliable tool for both thc scientist and the clinician for studying adrenal cortical function in the adult. We have measured salivary cortisol in samples from 138 healthy infants, children, and adolescents, and from 14 adults. Saliva samples were obtained at home using a cotton swab and a saliva-collecting tube at 800, 1300, and 1800 h before meals. Cortisol was measured using a time-resolved fluorcsccnt irnmunoassay. Cortisol levels in saliva ranged from less than 2 nmol/L up to more than 100 nmol/L. Cortisol levels were age-dependent. Intcrcstingly, after thc age of 6 y, cortisol levcls corrclated significantly with pubertal stages (analysis of variance). No sex difference was found. In addition, cortisol morning levels and daily cortisol levels (area under the curve from three measurements) increased with body weight and body mass index. The highest cortisol levels were measured in saliva of children younger than 1 y. No circadian variation was evident before thc agc of 9 mo. After 1 y of age, salivary cortisol levels varied in a circadian fashion. The measurement of salivary cortisol levels is an attractive way of testing adrenal function in infants and children. It provides a rcliable tool for the determination of the physiology and developmental characteristics of cortisol metabolism. (Pediatr Res 37: 502-506, 1995)The measurement of cortisol in saliva provides a reliable cents and from 1 4 adults to obtain more insight into regulatory tool for investigations of hypothalamus-pituitary-adrenal axis mechanisms of adrenal function throughout childhood and activity (1-1 1). Saliva samples can be obtained stress-free. In adolescents. addition, salivary cortisol reprcsents the free fraction of cortisol in plasma and does not depend on salivary sccretion rate (flow rate) nor on salivary protein content (4, 5, 9, 11). About METHODS 5-10% of total plasma cortisol is not bound to cortisol-binding Subjects and study protocol. Saliva samples were obtained globulin (= free plasma and diffuses into in the home setting at 800, 1300, and 1800 h before meals. saliva. Salivary cortisol measurements have been extensively Saliva samples were sent to the laboratory by surface mail. A used in psychobiologic, psychiatric, and endocrine re-complete medical examination was performed, and height, search. Surprisingly, relatively little information is available on weight, and pubertal stages were recorded by means of a the use of salivary cortisol determinations in children and standardized examination form. adolescents. Importantly, relatively few studies deal with the Height, weight, and body mass index values of the subjects diurnal variation of cortisol levels in children, developmental were all within the third to 97th percentile range (26). A total and physiologic aspects of function in young age, and of 178 healthy subjects were recruited from an inner city influ' ' ' ' of and pubertal On neighborhood (Munich, Germany), the local kindergarden, and cortisol levels (12)(13)(14)...

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“…It has been shown that determination of total glucocorticoid metabolites in 24-h urinary specimens reflects 75% of cortisol production rates in adults (5). It has also been convincingly shown that the urinary excretion rate of free cortisol does not correlate with cortisol production rate (22,23).…”

Section: Cortisol Production In Preterm Infantsmentioning

confidence: 99%

“…Cortisol production rates were reported for moderately premature infants (6.6 -8.8 mg/m 2 /d) using deconvolution analysis in plasma (24) and for older children (6.8 Ϯ 1.9 mg/m 2 /d) (23) or adults (7.7-11.4 mg/m 2 /d) (5) using a stable isotope dilution technique. The median urinary excretion rates of glucocorticoids in our infants reached up to 70% of these reported cortisol production rates.…”

Section: Cortisol Production In Preterm Infantsmentioning

confidence: 99%

Assessing Cortisol Production in Preterm Infants: Do Not Dispose of the Nappies

et al. 2005

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The aim of this study was to develop a practical approach allowing a reliable and noninvasive assessment of cortisol production rates in premature infants. To measure daily urinary excretion rates of glucocorticoids, we developed a procedure using a hydraulic compression method to collect urine from cellulose nappies (diapers). Glucocorticoid metabolites were profiled by quantitative gas chromatography-mass spectrometry. Recovery of steroids after the process of hydraulic extraction from the nappy was approximately 100%. Consecutively, urinary excretion rates of glucocorticoids could be determined in nine healthy preterm infants. The median urinary excretion rate of glucocorticoids increased significantly during the first 5 d of life and remained between 566 g/kg/d at d 5 and 302 g/kg/d at 4 wk of age. However, this increase of urinary excretion rates of glucocorticoids in the first days of life was no longer significant when corrected for creatinine excretion. When calculated per square meter body surface area, the median urinary excretion rates of glucocorticoids were 5.1, 4.2, 4.1, and 3.7 mg/m 2 /d on d 5, and at wk, 2, 3, and 4, respectively. Urinary excretion rates of glucocorticoids constitute approximately 70% of the natural cortisol production rate as determined by stable isotope dilution technique in older children. Additionally, low cortisol production was detected in two of five preterm infants with arterial hypotension requiring treatment with catecholamines. In conclusion, 24-h urine collection using disposable nappies in combination with gas chromatography-mass spectrometry steroid profiling proved to be a reliable, noninvasive, nonstressful procedure to assess cortisol production and metabolism in premature infants. The important question, whether early adrenal insufficiency-possibly associated with increased pulmonary and circulatory morbidity-might be present in premature babies, has not yet been answered (1-3). Studies addressing this problem have been based on single plasma cortisol determinations by immunoassays. However, a single plasma cortisol concentration does not present a timely integral parameter and therefore does not allow assessment of the level of the cortisol production rate. Furthermore, steroid determinations by immunoassays can be associated with severe problems arising from cross-reactivity of steroids, especially in premature infants. This is due to the peculiarity of fetal and neonatal steroid metabolism: large amounts of potentially cross-reactive steroid sulfates retaining a 3␤-hydroxy-5-ene structure are produced in the unique fetal zone of the adrenals (4). As a result, no commercially available cortisol immunoassays have been developed that are appropriate for use in measuring steroids in plasma from premature infants or neonates.A suitable scientific method allowing assessment of cortisol production rates in premature infants is still lacking. Such a procedure should ideally comprise measurement of the correct metabolites of glucocorticoid metabolism and should, for ...

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Cortisol production rate in childhood and adolescence

Cited by 183 publications

References 15 publications

Establishment of Reference Ranges for Cortisol in Neonates, Infants, Children and Adolescents

Establishment of Reference Ranges for Cortisol in Neonates, Infants, Children and Adolescents

Salivary Cortisol Levels throughout Childhood and Adolescence: Relation with Age, Pubertal Stage, and Weight

Assessing Cortisol Production in Preterm Infants: Do Not Dispose of the Nappies

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