The cortisol production rate in children: Implications for therapy

Fernando Cassorla, Barbara L. Linder, Nora V. Esteban, Alfred L. Yergey, Jorg C. Winterer, Donald (Lynn) Loriaux

Research output: Contribution to journalArticle

Abstract

We studied the daily cortisol production rate in 33 normal children and adolescents, ages 8–17 years, using a stable isotope-dilution technique employing high-performance liquid chromatography-mass spectrometry. Two indwelling intravenous catheters were inserted and deuterated cortisol was infused continuously for 30 hours. After 6 hours of tracer infusion to establish equilibrium, blood was obtained every 20 minutes for 24 hours for the measurement of deuterated cortisol. The cortisol production rate was calculated from the relative abundance of the deuterated cortisol. The cortisol production rate was 9.5 ± 2.5 mg/day or 6.8 ± 1.9 mg/M2/day (mean ± SD). Cortisol production rate did not vary with gender or pubertal stage (9.8 ± 2.8 mg/day or 7.3 ± 1.8 mg/M2/day in the girls and 9.1 ± 2.2 mg/day or 6.1 ± 1.8 mg/M2/day in the boys). These results suggest that the cortisol production rate in children and adolescents is only about half of that estimated by earlier studies using less discriminating techniques. Thus, the physiologic replacement dose of hydrocortisone for children may be lower than previously believed. This finding has implications for the treatment of diseases such as adrenal insufficiency and congenital adrenal hyperplasia.

Original languageEnglish (US)
Pages (from-to)98-101
Number of pages4
JournalEndocrinologist
Volume1
Issue number2
StatePublished - 1991
Externally publishedYes

Fingerprint

Hydrocortisone
Therapeutics
Indicator Dilution Techniques
Congenital Adrenal Hyperplasia
Adrenal Insufficiency
Indwelling Catheters
Isotopes
Mass Spectrometry
High Pressure Liquid Chromatography

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Cassorla, F., Linder, B. L., Esteban, N. V., Yergey, A. L., Winterer, J. C., & Loriaux, D. L. (1991). The cortisol production rate in children: Implications for therapy. Endocrinologist, 1(2), 98-101.

The cortisol production rate in children : Implications for therapy. / Cassorla, Fernando; Linder, Barbara L.; Esteban, Nora V.; Yergey, Alfred L.; Winterer, Jorg C.; Loriaux, Donald (Lynn).

In: Endocrinologist, Vol. 1, No. 2, 1991, p. 98-101.

Research output: Contribution to journalArticle

Cassorla, F, Linder, BL, Esteban, NV, Yergey, AL, Winterer, JC & Loriaux, DL 1991, 'The cortisol production rate in children: Implications for therapy', Endocrinologist, vol. 1, no. 2, pp. 98-101.
Cassorla F, Linder BL, Esteban NV, Yergey AL, Winterer JC, Loriaux DL. The cortisol production rate in children: Implications for therapy. Endocrinologist. 1991;1(2):98-101.
Cassorla, Fernando ; Linder, Barbara L. ; Esteban, Nora V. ; Yergey, Alfred L. ; Winterer, Jorg C. ; Loriaux, Donald (Lynn). / The cortisol production rate in children : Implications for therapy. In: Endocrinologist. 1991 ; Vol. 1, No. 2. pp. 98-101.
@article{3c736f1f95fe43b8b67e4d4bd104c254,
title = "The cortisol production rate in children: Implications for therapy",
abstract = "We studied the daily cortisol production rate in 33 normal children and adolescents, ages 8–17 years, using a stable isotope-dilution technique employing high-performance liquid chromatography-mass spectrometry. Two indwelling intravenous catheters were inserted and deuterated cortisol was infused continuously for 30 hours. After 6 hours of tracer infusion to establish equilibrium, blood was obtained every 20 minutes for 24 hours for the measurement of deuterated cortisol. The cortisol production rate was calculated from the relative abundance of the deuterated cortisol. The cortisol production rate was 9.5 ± 2.5 mg/day or 6.8 ± 1.9 mg/M2/day (mean ± SD). Cortisol production rate did not vary with gender or pubertal stage (9.8 ± 2.8 mg/day or 7.3 ± 1.8 mg/M2/day in the girls and 9.1 ± 2.2 mg/day or 6.1 ± 1.8 mg/M2/day in the boys). These results suggest that the cortisol production rate in children and adolescents is only about half of that estimated by earlier studies using less discriminating techniques. Thus, the physiologic replacement dose of hydrocortisone for children may be lower than previously believed. This finding has implications for the treatment of diseases such as adrenal insufficiency and congenital adrenal hyperplasia.",
author = "Fernando Cassorla and Linder, {Barbara L.} and Esteban, {Nora V.} and Yergey, {Alfred L.} and Winterer, {Jorg C.} and Loriaux, {Donald (Lynn)}",
year = "1991",
language = "English (US)",
volume = "1",
pages = "98--101",
journal = "Endocrinologist",
issn = "1051-2144",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The cortisol production rate in children

T2 - Implications for therapy

AU - Cassorla, Fernando

AU - Linder, Barbara L.

AU - Esteban, Nora V.

AU - Yergey, Alfred L.

AU - Winterer, Jorg C.

AU - Loriaux, Donald (Lynn)

PY - 1991

Y1 - 1991

N2 - We studied the daily cortisol production rate in 33 normal children and adolescents, ages 8–17 years, using a stable isotope-dilution technique employing high-performance liquid chromatography-mass spectrometry. Two indwelling intravenous catheters were inserted and deuterated cortisol was infused continuously for 30 hours. After 6 hours of tracer infusion to establish equilibrium, blood was obtained every 20 minutes for 24 hours for the measurement of deuterated cortisol. The cortisol production rate was calculated from the relative abundance of the deuterated cortisol. The cortisol production rate was 9.5 ± 2.5 mg/day or 6.8 ± 1.9 mg/M2/day (mean ± SD). Cortisol production rate did not vary with gender or pubertal stage (9.8 ± 2.8 mg/day or 7.3 ± 1.8 mg/M2/day in the girls and 9.1 ± 2.2 mg/day or 6.1 ± 1.8 mg/M2/day in the boys). These results suggest that the cortisol production rate in children and adolescents is only about half of that estimated by earlier studies using less discriminating techniques. Thus, the physiologic replacement dose of hydrocortisone for children may be lower than previously believed. This finding has implications for the treatment of diseases such as adrenal insufficiency and congenital adrenal hyperplasia.

AB - We studied the daily cortisol production rate in 33 normal children and adolescents, ages 8–17 years, using a stable isotope-dilution technique employing high-performance liquid chromatography-mass spectrometry. Two indwelling intravenous catheters were inserted and deuterated cortisol was infused continuously for 30 hours. After 6 hours of tracer infusion to establish equilibrium, blood was obtained every 20 minutes for 24 hours for the measurement of deuterated cortisol. The cortisol production rate was calculated from the relative abundance of the deuterated cortisol. The cortisol production rate was 9.5 ± 2.5 mg/day or 6.8 ± 1.9 mg/M2/day (mean ± SD). Cortisol production rate did not vary with gender or pubertal stage (9.8 ± 2.8 mg/day or 7.3 ± 1.8 mg/M2/day in the girls and 9.1 ± 2.2 mg/day or 6.1 ± 1.8 mg/M2/day in the boys). These results suggest that the cortisol production rate in children and adolescents is only about half of that estimated by earlier studies using less discriminating techniques. Thus, the physiologic replacement dose of hydrocortisone for children may be lower than previously believed. This finding has implications for the treatment of diseases such as adrenal insufficiency and congenital adrenal hyperplasia.

UR - http://www.scopus.com/inward/record.url?scp=84930098687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930098687&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84930098687

VL - 1

SP - 98

EP - 101

JO - Endocrinologist

JF - Endocrinologist

SN - 1051-2144

IS - 2

ER -