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Normative Data for Adrenal Steroidogenesis in a Healthy Pediatric Population: Age- and Sex-Related Changes after Adrenocorticotropin Stimulation^*

G. LASHANSKY, P. SAENGER, K. FISHMAN, T. GAUTIER, D. MAYES, G. BERG, J. DI MARTINO-NARDI and E. REITER

Department of Pediatrics, Division of Pediatric Endocrinology, Albert Einstein College of Medicine/Montefiore Medical Center Bronx, New York 10467
The Department of Pediatrics, Tufts University School of Medicine, Bay state Medical Center Springfield, Massachusetts 01199
The Department of Pediatrics, National University Santo Domingo, Dominican Republic
Endocrine Sciences Calabasas Hills, California 91301

Address all correspondence and requests for reprints to: Paul Saenger, M.D., Department of Pediatrics, Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467.

The normal response to a single 0.25-mg dose of ACTH-(l-24) is not well established in infancy or childhood. We report the adrenal steroidogenic responses of 17-hydroxypregnenolone (17OH Preg), 17-hydroxyprogesterone (17OH Prog), 11-deoxycortisol, cortisol, deoxycorticosterone, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione (A’dione), and testosterone in 102 healthy children who were divided into 5 groups: group 1 (<1 yr old; n = 22), group 2 (1-5 yr old; n = 22), group 3 (6-12 yr old; n = 15), group 4 (earlymidpuberty; n = 21), and group 5 (late puberty; n = 22). Baseline and stimulated levels of 17OH Preg were significantly higher in group 1 infants than in group 2 children (P < 0.01). Baseline levels of 17OH Prog increased in late puberty (P < 0.01). Baseline and stimulated levels of DHEA rose in late puberty (group 5 vs. group 3, P < 0.01). DHEA levels in late pubertal females were higher than those in their male counterparts (P < 0.01). DHEA sulfate levels did not change after ACTH administration in any age group. Basline and stimulated levels of A’dione rose significantly before the onset of puberty in female children (group 2 vs. group 3, P < 0.01). The calculated ratio of 17OH Preg/17OH Prog in group 1 was significantly higher than that in other groups of children (P < 0.01). The calculated, baseline DHEA/A’dione ratio was higher in group 1 than in older children (P < 0.01). Stimulated ratios were higher in late pubertal females than in males (P < 0.01). In both sexes baseline and stimulated ratios of 17OH Prog/deoxycorticosterone increased in puberty, such that late pubertal children had higher levels than prepubertal children (P < 0.01). These data confirm the need for interpretation ACTH stimulation test data to be based upon age- and sex-specific norms.

^* This work was supported in part by Training Grant in Investigative Endocrinology 2-T32-DK-07004–16.

fDeceased.

Received November 20, 1990.

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