ADRENAL-STEROID HORMONES IN SHORT CHILDREN BORN SMALL-FOR-GESTATIONAL-AGE

OBJECTIVE Programming of the endocrine axis has been postulated to occ ur during critical phases of fetal development and is affected by intr auterine growth retardation, The aim of this study was to investigate this hypothesis with regard to adrenal steroid hormones, Thus, serum c ortisol and dehydroepiandrosterone sulphate (DHEAS) levels were compar ed 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 sa mples for cortisol measurements were taken during a 24-h period from a total of 184 prepubertal individuals. The study group comprised 53 ch ildren born SGA who remained short (41 boys, 12 girls; mean chronologi cal 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 c hronological age, 10.8 +/- 2.6 years) and 56 healthy children of norma l height (37 boys, 19 girls; mean chronological age, 11.3 +/- 1.8 year s), A single serum sample for measurement of DHEAS was taken between 1 000 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 we re measured by radioimmunoassay, RESULTS No differences were found bet ween 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 amplitud e, No difference between the groups was found for serum DHEAS concentr ations. Serum cortisol levels, expressed as AUG, and serum DHEAS level s did not correlate with size at birth, However, when adjusted for age at investigation, serum DHEAS, but not serum cortisol, correlated wit h weight at birth, CONCLUSIONS Serum cortisol levels and rhythms do no t correlate with size at birth and are similar in children born small for gestational age who remain short and children born appropriate siz e 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.