Abstract
To assess total cortisol levels in children being evaluating for short stature with
normal cortisol reserve and to correlate this response to clinical and laboratory
data. Children assessed with glucagon test in our department were recruited in this
study retrospectively. Inclusion criteria were: i) age>1 year, ii) absence of chronic
illness or medication interfering with ACTH-cortisol axis, iii) GH stimulation levels>3ng/mL
at least in one provocation test (glucagon or clonidine), iv) absence of multiple
pituitary growth hormone deficiencies, v) normal short Synacthen test in cases of
low cortisol response in glucagon test.Two hundred and thirty-seven subjects (160
males, 67.5%) with a mean age of 9.02±3.19 years, were finally included in the analysis.
Cortisol peak levels but not cortisol AUC were significantly increased in females
compared to males (26.83±7.31 μg/dl vs. 24.04±7.20 μg/dl). When linear correlations
were studied, both cortisol peak levels and cortisol AUC were linearly but inversely
correlated to age (r=−0.234, p<0.001 and r=−0.315, p<0.001, respectively). Finally,
cortisol AUC was inversely correlated to weight Z-scores (r=−0.160, p=0.014). When
our analysis was limited only to subjects with intact GH response (GH peak> 7 ng/mL),
age was still inversely correlated to cortisol AUC (r=−0.312, p<0.001), and cortisol
AUC was linearly correlated to GH AUC assessed with clonidine test (r=0.223, p=0.013).
Girls, younger and thinner children exhibit higher cortisol response to glucagon test.
Key words
cortisol - glucagon stimulation test - growth hormone - clonidine stimulation test
