Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
Horm Res Paediatr. 2012;77(5):298-304. doi: 10.1159/000338344. Epub 2012 May 31.
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).
To compare adrenocortical hormonal activity between 20-year-old subjects born SGA or AGA.
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.
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.
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.
肾上腺皮质活动的改变是将出生时体重较小与成年期代谢综合征联系起来的一个机制。出生体重较小（SGA）的儿童的肾上腺雄激素浓度高于适合胎龄（AGA）的儿童。
比较出生时体重较小（SGA）和出生时体重正常（AGA）的 20 岁受试者的肾上腺皮质激素活性。
研究了 70 名 20 岁的受试者（35 名 SGA 和 35 名年龄和性别匹配的 AGA 对照组）。测量了血清皮质醇、皮质酮、皮质类固醇结合球蛋白（CBG）、糖皮质激素生物活性（GBA）、醛固酮、硫酸脱氢表雄酮（DHEAS）和雄烯二酮，并计算了游离皮质醇指数（FCI）。
SGA 和 AGA 组之间的糖皮质激素参数、醛固酮、DHEAS 或雄烯二酮的平均水平没有差异。在两组中，男性的皮质醇（p<0.05）和 CBG 水平（p<0.01）较低，而 DHEAS 浓度较高（p<0.01）。使用激素避孕药的女性的皮质醇和 CBG 水平较高（p<0.01），但 FCI、GBA 和 DHEAS 水平与未使用避孕药的女性相似。
20 岁的 SGA 和 AGA 受试者之间的肾上腺皮质活性没有差异。足月出生的 SGA 受试者在青春期后肾上腺雄激素分泌增强似乎在成年早期消失。FCI 和 GBA 是评估激素避孕药使用期间糖皮质激素环境的有用参数。
