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Birthsize, gestational age and adrenal function in adult life: studies of dexamethasone suppression and ACTH1-24 stimulation

Birthsize, gestational age and adrenal function in adult life: studies of dexamethasone suppression and ACTH1-24 stimulation
Birthsize, gestational age and adrenal function in adult life: studies of dexamethasone suppression and ACTH1-24 stimulation
OBJECTIVE: Several studies show that low birthweight is associated with long-term alterations in the function of the hypothalamic-pituitary-adrenal axis (HPAA). We recently reported that the relationship between birthweight and fasting serum cortisol concentrations differed according to the gestational age of the babies, suggesting that both hypercortisolism and hypocortisolism could be a consequence of impaired fetal growth. We have now extended these findings by examining the relationship between birthweight, gestational age and tests of adrenal suppression and stimulation. DESIGN: Prospective birth cohort study. SUBJECTS AND METHODS: We studied 165 women (mean age 71.3 Years) born at term in Helsinki, Finland, between 1924 and 1933, whose body size and gestational age at birth were recorded. These women underwent an overnight 0.25 mg dexamethasone suppression test followed by a 1 microg ACTH(1-24) stimulation test. RESULTS: In all women combined, low birthweight was associated with lower total (P=0.03) and free (P=0.02) cortisol concentrations following dexamethasone. However, these relationships were dependent on gestational age at birth, interactions between the effects of birth size and gestational age on dexamethasone responsiveness being statistically significant. To demonstrate these interactions, we divided the study population into two groups according to gestational age. In subjects born at 40 weeks of gestation or more, low birthweight was strongly associated with enhanced dexamethasone suppression (P=0.003 for total and P=0.0004 for free cortisol), while in subjects born before 40 weeks of gestation there was no association. There was, however, no correlation between birth size and the adrenal response to ACTH(1-24). CONCLUSIONS: These findings reinforce our suggestions that events during prenatal life may lead to both up-regulation and down-regulation of the HPAA.
infant, research support, population, adult, non-u.s.gov't, risk factors, dexamethasone, body size, newborn, birth weight, birth, adrenal cortex function tests, hypothalamo-hypophyseal system, cohort, hydrocortisone, up-regulation, low birth weight, body mass index, diagnostic use, physiology, humans, peptide fragments, pituitary-adrenal system, public health, design, prospective studies, gestational age, finland, cortisol, corticotropin, cohort studies, fasting, adrenal cortex, middle aged, health, growth, female, blood, p.h.s., methods, comparative study, down-regulation, aged, fetal
0804-4643
569-575
Kajantie, E.
d4e32f85-9988-4b83-b353-012210ea0151
Eriksson, J.
e82bcabe-c143-4fc5-9755-a03639b52b2c
Barker, D.J.
cabc3433-b628-43e5-9fd7-e6ff5769bf44
Forsen, T.
009ce53c-8bbf-4c5c-a21f-0bbdd1f999c4
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Andersson, S.
f7fd5a29-9c9c-4c8e-a96d-6aef9308b0a0
Dunkel, L.
7e07c1a7-fd01-40f4-ae98-bef832dbd75b
Phillips, D.I.
29b73be7-2ff9-4fff-ae42-d59842df4cc6
Kajantie, E.
d4e32f85-9988-4b83-b353-012210ea0151
Eriksson, J.
e82bcabe-c143-4fc5-9755-a03639b52b2c
Barker, D.J.
cabc3433-b628-43e5-9fd7-e6ff5769bf44
Forsen, T.
009ce53c-8bbf-4c5c-a21f-0bbdd1f999c4
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Andersson, S.
f7fd5a29-9c9c-4c8e-a96d-6aef9308b0a0
Dunkel, L.
7e07c1a7-fd01-40f4-ae98-bef832dbd75b
Phillips, D.I.
29b73be7-2ff9-4fff-ae42-d59842df4cc6

Kajantie, E., Eriksson, J., Barker, D.J., Forsen, T., Osmond, C., Wood, P.J., Andersson, S., Dunkel, L. and Phillips, D.I. (2003) Birthsize, gestational age and adrenal function in adult life: studies of dexamethasone suppression and ACTH1-24 stimulation. European journal of endocrinology, 149 (6), 569-575. (doi:10.1530/eje.0.1490569).

Record type: Article

Abstract

OBJECTIVE: Several studies show that low birthweight is associated with long-term alterations in the function of the hypothalamic-pituitary-adrenal axis (HPAA). We recently reported that the relationship between birthweight and fasting serum cortisol concentrations differed according to the gestational age of the babies, suggesting that both hypercortisolism and hypocortisolism could be a consequence of impaired fetal growth. We have now extended these findings by examining the relationship between birthweight, gestational age and tests of adrenal suppression and stimulation. DESIGN: Prospective birth cohort study. SUBJECTS AND METHODS: We studied 165 women (mean age 71.3 Years) born at term in Helsinki, Finland, between 1924 and 1933, whose body size and gestational age at birth were recorded. These women underwent an overnight 0.25 mg dexamethasone suppression test followed by a 1 microg ACTH(1-24) stimulation test. RESULTS: In all women combined, low birthweight was associated with lower total (P=0.03) and free (P=0.02) cortisol concentrations following dexamethasone. However, these relationships were dependent on gestational age at birth, interactions between the effects of birth size and gestational age on dexamethasone responsiveness being statistically significant. To demonstrate these interactions, we divided the study population into two groups according to gestational age. In subjects born at 40 weeks of gestation or more, low birthweight was strongly associated with enhanced dexamethasone suppression (P=0.003 for total and P=0.0004 for free cortisol), while in subjects born before 40 weeks of gestation there was no association. There was, however, no correlation between birth size and the adrenal response to ACTH(1-24). CONCLUSIONS: These findings reinforce our suggestions that events during prenatal life may lead to both up-regulation and down-regulation of the HPAA.

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More information

Published date: December 2003
Keywords: infant, research support, population, adult, non-u.s.gov't, risk factors, dexamethasone, body size, newborn, birth weight, birth, adrenal cortex function tests, hypothalamo-hypophyseal system, cohort, hydrocortisone, up-regulation, low birth weight, body mass index, diagnostic use, physiology, humans, peptide fragments, pituitary-adrenal system, public health, design, prospective studies, gestational age, finland, cortisol, corticotropin, cohort studies, fasting, adrenal cortex, middle aged, health, growth, female, blood, p.h.s., methods, comparative study, down-regulation, aged, fetal

Identifiers

Local EPrints ID: 59904
URI: http://eprints.soton.ac.uk/id/eprint/59904
ISSN: 0804-4643
PURE UUID: 24299f96-dbc8-4596-b5c0-417fd2f857ee
ORCID for C. Osmond: ORCID iD orcid.org/0000-0002-9054-4655

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Date deposited: 05 Sep 2008
Last modified: 16 Mar 2024 02:50

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Contributors

Author: E. Kajantie
Author: J. Eriksson
Author: D.J. Barker
Author: T. Forsen
Author: C. Osmond ORCID iD
Author: P.J. Wood
Author: S. Andersson
Author: L. Dunkel
Author: D.I. Phillips

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