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Circadian Cortisol Rhythms in Healthy Boys and Girls: Relationship with Age, Growth, Body Composition, and Pubertal Development¹

Department of Otorhinolaryngology (U.K., P.S.) and the Unit for Endocrinology (C.M., M.B.), Department of Pediatrics, Karolinska Institute, Huddinge University Hospital, Stockholm; and International Pediatric Growth Research Center, Department of Pediatrics (J.D., S.R., K.A.-W.), University of Göteborg, Göteborg, Sweden

Address all correspondence and requests for reprints to: Dr. Kerstin Albertsson-Wikland, University of Goteborg, Department of Pediatrics, International Pediatric Growth Research Center, East Hospital, S-416 85 Goteborg, Sweden. E-mail: Kerstin.Albertsson{at}pediat.gu.se

To provide basic information on the normal functioning of the hypothalamus-pituitary-adrenal axis in relation to pubertal development, growth (weight and height), body composition, and gender and to obtain reference data for serum cortisol concentrations in children, we investigated the basal circadian rhythm of serum cortisol in a group of 235 healthy children (162 boys and 73 girls). The age range was between 2.2–18.5 yr. Serum cortisol was analyzed from venous blood samples taken at 1400, 1800, 2200, 0200, 0400, 0600, and 1000 h. No evidence was found for differences in temporal placement or level of the circadian cortisol rhythm in relation to age, growth, or body composition. However, we found a broad range of cortisol levels in a healthy population, with individual mean diurnal levels ranging from 100–510 nmol/L. Regardless of high or low mean diurnal cortisol levels, repeated measurements within and between pubertal stages indicated that an individual remains in his or her cortisol range throughout pubertal development. In conclusion, the present study shows that 1) serum cortisol levels do not correlate with either age or gender; 2) there is a large and significant interindividual variability in endogenous mean diurnal cortisol levels; and 3) despite this variability between individuals, there is no correlation between cortisol levels and either body composition or growth rate. This suggests that the variability in cortisol levels is an expression of normal homeostasis rather than pathology.

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