Department of Paediatrics, Oslo University Hospital, Ullevål, Oslo, Norway.
Acta Paediatr. 2010 Nov;99(11):1705-11. doi: 10.1111/j.1651-2227.2009.01598.x.
Reduced basal cortisol is reported in allergic disease. We investigated if basal salivary cortisol levels were reduced in children with asthma or allergic rhinitis, controlling for inhaled corticosteroids (ICS) use.
Morning and evening saliva of asthmatic children aged 7-12 years (n = 50) and that of controls (n = 52) were sampled. A total of 19 asthmatics and four controls had allergic rhinitis. Healthy children were controls without rhinitis. Of all, 14 asthmatic children used low, and 12 used moderate or high doses of ICS. Cortisol was analysed by radioimmunoassay.
Morning salivary cortisol median (95% CI) was lower in asthmatics (8.7 (7.1, 9.7)) compared with that in controls (10.4 (9.6, 11.8); p = 0.006), which was similar for evening cortisol levels. Regression analyses demonstrated that asthmatics using moderate or high doses of ICS had reduced morning salivary cortisol adjusted (for age and gender) odds ratio (aOR) (95% CI) (0.54 (0.37, 0.80); p = 0.002) and reduced evening cortisol aOR (0.09 (0.01, 0.6); p = 0.02) compared with that in healthy children. Asthmatics with rhinitis on no or low doses of ICS had reduced morning cortisol aOR (0.73 (0.56, 0.96); p = 0.02) compared with that in healthy children.
Asthmatic children on moderate or high doses of inhaled corticosteroids had reduced salivary cortisol, but co-morbidity of asthma and rhinitis was also associated with reduced cortisol levels.
过敏性疾病患者的基础皮质醇水平降低。我们研究了在控制吸入皮质类固醇(ICS)使用的情况下,哮喘或过敏性鼻炎患儿的基础唾液皮质醇水平是否降低。
采集 7-12 岁哮喘儿童(n=50)和对照组儿童(n=52)的晨、晚唾液样本。共有 19 名哮喘儿童和 4 名对照儿童患有过敏性鼻炎。健康儿童为无鼻炎对照。所有儿童中,14 名哮喘儿童使用低剂量 ICS,12 名使用中或高剂量 ICS。皮质醇通过放射免疫分析进行分析。
与对照组相比,哮喘患儿的晨唾液皮质醇中位数(95%CI)较低(8.7(7.1,9.7)比 10.4(9.6,11.8);p=0.006),夜间皮质醇水平也类似。回归分析表明,使用中或高剂量 ICS 的哮喘患儿晨唾液皮质醇调整(按年龄和性别)比值比(aOR)(95%CI)(0.54(0.37,0.80);p=0.002)和夜间皮质醇 aOR(0.09(0.01,0.6);p=0.02)降低,与健康儿童相比。未使用或低剂量 ICS 的哮喘合并鼻炎患儿的晨皮质醇 aOR(0.73(0.56,0.96);p=0.02)与健康儿童相比降低。
使用中或高剂量吸入皮质类固醇的哮喘儿童唾液皮质醇降低,但哮喘和鼻炎的合并症也与皮质醇水平降低有关。