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Elevated Plasma Cortisol Concentrations


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I was born weighing around 6 lbs. How about you guys?

Interesting articles.






Original Studies


Elevated Plasma Cortisol Concentrations: A Link between Low Birth Weight and the Insulin Resistance Syndrome?1

D. I. W. Phillips, D. J. P. Barker, C. H. D. Fall, J. R. Seckl, C. B. Whorwood, P. J. Wood and B. R. Walker

Medical Research Council Environmental Epidemiology Unit, University of Southampton (D.I.W.P., D.J.P.B., C.H.D.F, C.B.W.), and the Regional Endocrine Unit, Southampton General Hospital (P.W.), Southampton, United Kingdom; and the Department of Medicine, University of Edinburgh, Western General Hospital (J.R.S., B.R.W.), Edinburgh, Scotland


Address all correspondence and requests for reprints to: Dr. D. I. W. Phillips, Medical Research Council Unit, Southampton General Hospital, Tremona Road, Southampton, United Kingdom SO16 6YD. E-mail: diwp@mrc.soton.ac.uk.


Recent studies have shown that reduced fetal growth is associated with the development of the insulin resistance syndrome in adult life. The mechanisms are not known. However increased activity of the hypothalamic-pituitary-adrenal axis (HPAA) may underlie this association; the axis is known to be reset by fetal growth retardation in animals, and there is evidence in humans of an association between raised HPAA activity and the insulin resistance syndrome. We have, therefore, examined the relations among size at birth, plasma cortisol concentrations, and components of the insulin resistance syndrome in a sample of healthy men. We measured 0900 h fasting plasma cortisol and corticosteroid-binding globulin levels in 370 men who were born in Hertfordshire, UK, between 1920?1930 and whose birth weights were recorded. Fasting plasma cortisol concentrations varied from 112?702 nmol/L and were related to systolic blood pressure (P = 0.02), fasting and 2-h plasma glucose concentrations after an oral glucose tolerance test (P = 0.0002 and P = 0.04), plasma triglyceride levels (P = 0.009), and insulin resistance (P = 0.006). Plasma cortisol concentrations fell progressively (P = 0.007) from 408 nmol/L in men whose birth weights were 5.5 lb (2.50 kg) or less to 309 nmol/L among those who weighed 9.5 lb (4.31 kg) or more at birth, a trend independent of age and body mass index. These findings suggest that plasma concentrations of cortisol within the normal range could have an important effect on blood pressure and glucose tolerance. Moreover, this study provides the first evidence that intrauterine programming of the HPAA may be a mechanism underlying the association between low birth weight and the insulin resistance syndrome in adult life.





Body Size at Birth Predicts Hypothalamic-Pituitary-Adrenal Axis Response to Psychosocial Stress at Age 60 to 70 Years

Eero Kajantie, Kimmo Feldt, Katri R?ikk?nen, David I. W. Phillips, Clive Osmond, Kati Heinonen, Anu-Katriina Pesonen, Sture Andersson, David J. P. Barker and Johan G. Eriksson

Department of Health Promotion and Chronic Disease Prevention (E.K., J.G.E.), National Public Health Institute, 00300 Helsinki, Finland; Hospital for Children and Adolescents (E.K., S.A.), Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland; Departments of Psychology (K.F., K.R., K.H., A.-K.P.) and Public Health (J.G.E.), University of Helsinki, 00014 Helsinki, Finland; Medical Research Council Epidemiology Resource Centre and Developmental Origins of Health and Disease Division (D.I.W.P., C.O., D.J.P.B.), University of Southampton, Southampton SO16 6YD, United Kingdom; and Department of Medicine (D.J.P.B.), Heart Research Center, Oregon Health and Sciences University, Portland, Oregon 97201-3098


Address all correspondence and requests for reprints to: Eero Kajantie, M.D., Ph.D., National Public Health Institute, Department of Health Promotion and Chronic Disease Prevention, Mannerheimintie 166, 00300 Helsinki, Finland. E-mail: eero.kajantie@helsinki.fi.


Background: Studies in humans and animals have suggested intrauterine programming of hypothalamic-pituitary-adrenal axis (HPAA) function as an important mechanism in linking fetal life conditions with adult disease.


Objective: Our aim was to assess how body size at birth, a marker of intrauterine conditions, is associated with hypothalamic-pituitary-adrenal axis response to psychosocial stress in late adulthood.


Design and Setting: We conducted a clinical study in the Helsinki Birth Cohort.


Participants: Two hundred eighty-seven men and women born between 1934 and 1944 whose birth measurements and gestational age came from hospital records participated in the study.


Measurements: We measured salivary cortisol and, for 215 individuals, plasma cortisol and ACTH concentrations in conjunction with a standardized psychosocial stressor (Trier Social Stress Test).


Results: There was a linear relationship between low birth weight and low plasma ACTH but no linear relationship with cortisol. There were, however, quadratic relationships between birth weight and salivary (mixed model P = 0.001) and plasma cortisol (P = 0.005) but not with plasma ACTH (P = 0.1). The lowest peak salivary cortisol concentrations were seen in the lowest third of birth weights (adjusted for gestational age and sex): 12.9 nmol/liter (95% confidence interval of mean 11.2?15.0), compared with 17.1 nmol/liter (14.8?19.8) in the middle and 14.1 nmol/liter (12.6?15.7) in the highest third of birth weights. Corresponding figures for plasma cortisol were 418 nmol/liter (380?459), 498 nmol/liter (455?545), and 454 nmol/liter (428?482), and for plasma ACTH 8.17 pmol/liter (6.98?9.57), 12.42 pmol/liter (10.64?14.51), and 11.50 (10.06?13.14), respectively. Results for areas under the curve were similar.


Conclusions: We found an inverse U-shaped relationship between birth weight and cortisol concentrations during psychosocial stress. The lowest cortisol and ACTH concentrations were seen in subjects with the lowest birth weights. These results support the hypothesis that both hyper- and hypocortisolism may be programmed during the fetal period.

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