Adrenocortical Hormonal Activity in 20-Year-Old Subjects Born Small or Appropriate for Gestational Age

Abstract

Background: Altered adrenocortical activity is one suggested mechanism relating small birth size with the metabolic syndrome in adulthood. Adrenal androgen concentrations are higher in children born small (SGA) than appropriate for gestational age (AGA). Aim: To compare adrenocortical hormonal activity between 20-year-old subjects born SGA or AGA. Methods: Seventy 20-year-old subjects (35 SGA and 35 age- and gender-matched AGA controls) were studied. Serum cortisol, cortisone, corticosteroid-binding globulin (CBG), glucocorticoid bioactivity (GBA), aldosterone, dehydroepiandrosterone sulfate (DHEAS) and androstenedione were measured, and the free cortisol index (FCI) was calculated. Results: The mean levels of glucocorticoid parameters, aldosterone, DHEAS or androstenedione did not differ between the SGA and AGA groups. In both groups, the males had lower cortisol (p < 0.05) and CBG levels (p < 0.01) and higher DHEAS (p < 0.01) concentrations than the females. Females who used hormonal contraceptives had higher cortisol and CBG levels (p < 0.01) but similar FCI, GBA and DHEAS levels than females who did not use contraceptives. Conclusion: No differences in adrenocortical activity were found between 20-year-old SGA and AGA subjects. Enhanced peripubertal adrenal androgen secretion seems to disappear by early adulthood in full-term born SGA subjects. FCI and GBA are useful parameters in the evaluation of the glucocorticoid milieu during hormonal contraceptive use.

Increased Steroid Excretion in Children with Extremely Low Birth Weight at a Median Age of 9.8 years

“…In addition, Szathmári et al [22] reported higher serum DHEAS levels in 20-year-old prematurely born women (range 27-36 weeks) than in men in comparison with full-term-born controls. However, some reports found that the same group of patients had elevated DHEAS at prepuberty with no detectable difference in adulthood [31,32]. Follow-up of our patients will show whether the differences described here remain into adulthood.…”

Puberty in Children Born Small for Gestational Age

“…Insulin resistance and high levels of free IGF-I stimulate adrenal androgen secretion and the development of precocious pubarche [7,16,25,26]. However, there is some evidence that enhanced peripubertal adrenal androgen secretion disappears by early adulthood in SGA subjects born full term [27]. …”

Response to the Letter to the Editor Regarding the Article: Reference values for serum dehydroepiandrosterone‐sulphate in healthy children and adolescents with emphasis on the age of adrenarche and pubarche

“…Based on these findings, we believe that potential bias of IUGR on suggested DHEA‐S values was excluded. Additionally, findings of several previous studies also did not confirm associations between SGA status and premature adrenarche/serum DHEA‐S levels . Similarly in follow‐up studies of SGA cohorts, very few SGA‐born children have been reported to develop premature adrenarche …”

“…Additionally, findings of several previous studies also did not confirm associations between SGA status and premature adrenarche/ serum DHEA-S levels. [6][7][8] Similarly in follow-up studies of SGA cohorts, very few SGA-born children have been reported to develop premature adrenarche. 9 Ahmet Ucar also indicated that due to DHEA-S and androstenedione being week androgens, the validity of the serum DHEA-S cut-off values at the transition from PH1 to PH2 suggested by Guran et al warrants reconsideration and that such a cut-off value is only possible with a longitudinal study.…”