Adrenal function in children born small for gestational age

Abstract

Background: Subjects born small for gestational age (SGA) were shown to be at higher risk to metabolic consequences later in life and this might be related to changes in hypothalamic– pituitary–adrenal axis. Objective and hypotheses: We aimed to investigate DHEAS and cortisol levels in adolescents born SGA or appropriate for gestational age (AGA) and their relationship with perinatal and postnatal factors. Method: A prospective cohort of 46 SGA and 94 AGA children was followed-up from birth to adolescence (75 boys and 71 girls). At the time of the investigation, study subjects were 11–14 years old (median 13.2±2.1 years). Statistical analyses of DHEAS concentration were adjusted for sex, age and pubertal stage, and that of Cortisol concentration – for sex and BMI SDS. Results: SGA children had higher DHEAS levels than those born AGA (4.49±2.65 mmol/l vs 4.15±2.29 mmol/l; P=0.007). Analysing boys and girls separately, the difference wassignificant only in SGA boys (4.97±2.82 mmol/l vs 4.27±2.22 mmol/l; P=0.017). DHEAS levels were inversely associated with birth weight, birth length and gestational age (r=-0.241, P=0.004; r=-.230, P=0.006; r=-0.241, P=0.004, respectively), and in the AGA group directly associated with current BMI SDS (r=0.244, P=0.018). There was no difference in cortisol levels between SGA and AGA groups. Analysing by gender, SGA girls had lower cortisol concentration than AGA girls (254.4±82.4 nmol/l vs 382.1±224.7 nmol/l; P=0.01). Conclusion: Small size at birth and higher BMI at puberty is related to higher DHEAS levels in pubertal children. Funding information: This study was funded by the Lithuanian[...].