Adrenal Function in Adolescence is Related to Intrauterine and Postnatal Growth

Abstract

Background and objectives: Intrauterine growth restriction is thought to be implicated in long-term programming of hypothalamic–pituitary–adrenal axis activity. We investigated adrenal function in adolescents born small for gestational age (SGA) in relation to their postnatal growth and cardiovascular parameters. Materials and Methods: Anthropometric parameters, blood pressure, heart rate, dehydroepiandrosterone sulfate (DHEAS), and cortisol levels were assessed in 102 adolescents aged 11–14 years followed from birth (47 SGA and 55 born appropriate for gestational age (AGA)). Results: Mean DHEAS levels were higher in SGA adolescents with catch-up growth (SGACU+), compared with AGA. Second-year height velocity and body mass index (BMI) gain during preschool years were positively related to DHEAS levels. Morning cortisol levels and systolic and diastolic blood pressure were higher in SGA adolescents without catch-up growth (SGACU−) compared with AGA. Second-year BMI gain was inversely, and 2–12 years increase in subscapular skinfold thickness was directly associated with cortisol levels. Size at birth and postnatal growth explained 47.8% and 38.2% of variation in DHEAS and cortisol levels, respectively. Conclusion: Adrenal function in adolescence is affected by prenatal and postnatal growth: small size at birth with postnatal catch-up growth is related to higher DHEAS secretion, whereas increased cortisol levels and blood pressure are higher in short SGA adolescents.

Endocrine Dysfunction in Children with Zika-Related Microcephaly Who Were Born during the 2015 Epidemic in the State of Pernambuco, Brazil

“…SGA children with catch-up develop relatively high DHEAS levels. The progressive increase in serum SDHEA concentration that is characteristic of early adrenarche may promote bone age advancement with linear growth [ 35 , 36 , 37 ]. However, children who are born SGA may continue to have short stature [ 33 ].…”

Adrenal androgen trajectories are established during childhood in preterm boys

“…1 However, studies have suggested that the postnatal catch-up growth during infancy and childhood is even more potent in increasing adrenal activity compared with birth weight in children born small for gestational age (SGA). 6,7 A relationship between lower birth weight and more pronounced childhood adrenal androgen secretion is also found in children with normal birth weights. 8 Adrenal androgen secretion in healthy children has also been related to both current weight and catch-up in weight standard deviation score (SDS) from birth to three years of age.…”

“…Adrenal androgen secretion in healthy children has also been related to both current weight and catch‐up in weight standard deviation score (SDS) from birth to three years of age 8 . Furthermore, increased sex steroid hormone secretion has been found to induce increased insulin resistance, which promotes growth, and changed body composition 7 . There has been a lack of longitudinal studies of adrenal androgen secretion during childhood, but large cross‐sectional studies have reported that both DHEAS and androstenedione increase with age 9,10 …”

“…Low birth weight has been associated with premature adrenarche and increased risks of developing metabolic syndrome in adult life 1 . However, studies have suggested that the postnatal catch‐up growth during infancy and childhood is even more potent in increasing adrenal activity compared with birth weight in children born small for gestational age (SGA) 6,7 . A relationship between lower birth weight and more pronounced childhood adrenal androgen secretion is also found in children with normal birth weights 8 .…”

“…8 Furthermore, increased sex steroid hormone secretion has been found to induce increased insulin resistance, which promotes growth, and changed body composition. 7 There has been a lack of longitudinal studies of adrenal androgen secretion during childhood, but large cross-sectional studies have reported that both DHEAS and androstenedione increase with age. 9,10 Our research formed part of an ongoing, prospective, singlecentre study that investigated the relationship between gestational age, birth size, anthropometric parameters and adrenal androgen secretion during childhood.…”