Dahlgren J, Boguszewski M, Rosberg S, Albertsson-Wikland K
Department of Paediatrics, University of Göteborg, Sweden.
Clin Endocrinol (Oxf). 1998 Sep;49(3):353-61. doi: 10.1046/j.1365-2265.1998.00514.x.
Programming of the endocrine axis has been postulated to occur during critical phases of fetal development and is affected by intrauterine growth retardation. The aim of this study was to investigate this hypothesis with regard to adrenal steroid hormones. Thus, serum cortisol and dehydroepiandrosterone sulphate (DHEAS) levels were compared in children born small for gestational age (SGA) who remained short and in children born at an appropriate size for gestational age (AGA), of both short and normal stature.
Seven serum samples for cortisol measurements were taken during a 24-h period from a total of 184 prepubertal individuals. The study group comprised 53 children born SGA who remained short (41 boys, 12 girls; mean chronological age, 8.8 +/- 2.5 years). The reference groups of children born AGA were as follows: 75 healthy short children (56 boys, 19 girls; mean chronological age, 10.8 +/- 2.6 years) and 56 healthy children of normal height (37 boys, 19 girls; mean chronological age, 11.3 +/- 1.8 years). A single serum sample for measurement of DHEAS was taken between 1000 and 1400 h in 110 of the 184 children (33 short SGA, 42 short AGA and 35 AGA of normal height).
Serum cortisol and DHEAS were measured by radioimmunoassay.
No differences were found between children born SGA and children born AGA in either cortisol levels, calculated as area under the curve (AUC), or the circadian cortisol rhythm, estimated from the calculated nadir, the peak and the amplitude. No difference between the groups was found for serum DHEAS concentrations. Serum cortisol levels, expressed as AUC, and serum DHEAS levels did not correlate with size at birth. However, when adjusted for age at investigation, serum DHEAS, but not serum cortisol, correlated with weight at birth.
Serum cortisol levels and rhythms do not correlate with size at birth and are similar in children born small for gestational age who remain short and children born appropriate size for gestational age of both short and normal stature. However, DHEAS levels in young children before adrenarche correlated inversely with weight at birth, indicating a relationship with fetal growth.
内分泌轴的编程被假定发生在胎儿发育的关键阶段，并受宫内生长迟缓的影响。本研究的目的是就肾上腺类固醇激素对这一假设进行调查。因此，对出生时小于胎龄（SGA）且身材矮小的儿童以及出生时适于胎龄（AGA）的身材矮小和正常身材的儿童的血清皮质醇和硫酸脱氢表雄酮（DHEAS）水平进行了比较。
在24小时内从总共184名青春期前个体采集了7份用于皮质醇测量的血清样本。研究组包括53名出生时SGA且身材矮小的儿童（41名男孩，12名女孩；平均实足年龄，8.8±2.5岁）。出生时AGA的儿童参考组如下：75名健康的身材矮小儿童（56名男孩，19名女孩；平均实足年龄，10.8±2.6岁）和56名身高正常的健康儿童（37名男孩，19名女孩；平均实足年龄，11.3±1.8岁）。在184名儿童中的110名（33名身材矮小的SGA、42名身材矮小的AGA和35名身高正常的AGA）于1,000至1,400时采集了一份用于DHEAS测量的血清样本。
采用放射免疫分析法测量血清皮质醇和DHEAS。
出生时SGA的儿童与出生时AGA的儿童在以曲线下面积（AUC）计算的皮质醇水平或根据计算出的最低点、峰值和幅度估计的昼夜皮质醇节律方面均未发现差异。两组之间的血清DHEAS浓度也未发现差异。以AUC表示的血清皮质醇水平和血清DHEAS水平与出生时的大小无关。然而，在根据调查时的年龄进行调整后，血清DHEAS与出生体重相关，而血清皮质醇则不然。
血清皮质醇水平和节律与出生时的大小无关，在出生时小于胎龄且身材矮小的儿童与出生时适于胎龄的身材矮小和正常身材的儿童中相似。然而，青春期前幼儿的DHEAS水平与出生体重呈负相关，表明与胎儿生长有关。
