Intrauterine growth and the maturation process of adrenal function
Intrauterine growth and the maturation process of adrenal function
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DOI：
10.7717/peerj.6368
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发表时间：
2019-02-07
期刊：
影响因子：
2.7
通讯作者：
Iwata, Osuke
中科院分区：
文献类型：
--
作者：
Iwata, Sachiko;Kinoshita, Masahiro;Iwata, Osuke
背景：生命早期的环境因素改变了下丘脑-垂体-肾上腺(HPA)轴的调节，增加了晚年疾病的风险。然而，每个发育阶段的肾上腺功能与病理性产前疾病的关系还没有得到充分的研究。患有宫内生长受限(IUGR)的新生儿在新生儿期皮质醇水平升高；然而，当在儿童早期进行研究时，皮质醇水平低于他们的同龄人，这表明HPA轴的调节可能从激活转变为抑制，具体时间尚不确定。目的：本研究的目的是评估在新生儿重症监护病房住院的新生儿中，宫内发育和出生后年龄之间是否存在皮质醇水平的交互作用。方法：我们使用62例30至40周矫正年龄的新生儿唾液样本进行二次分析。结果：出生体重和IUGR的Z分数与出生后14天的皮质醇水平存在显著的交互作用；出生后14天的皮质醇水平高于无IUGR的同龄人。结论：IUGR新生儿的肾上腺功能在出生后几周内可能由激活状态变为抑制状态。纵向研究需要解决IUGR何时/如何改变肾上腺功能，以及这些反应如何与成年期间的疾病相关。
Backgrounds: Environmental factors during early life alter the hypothalamus-pituitary-adrenal (HPA) axis regulation and increase the risk of diseases in later life. However, adrenal function at each developmental stage has not fully been investigated in relation to pathological antenatal conditions. Cortisol levels of newborns with intrauterine growth restriction (IUGR) are elevated during the neonatal period; however, when studied during early childhood, cortisol levels are reduced compared with their peers, suggesting that the HPA axis regulation might be altered from activation to suppression, the timing of which remains uncertain.Aim: The aim of this study was to assess the presence of an interaction between intrauterine growth and postnatal age on cortisol levels in newborns hospitalised at a neonatal intensive care unit.Methods: We performed a secondary analysis using a dataset from saliva samples of 62 newborns collected between 30 and 40 weeks corrected age. Interactions between postnatal age and clinical variables with regard to cortisol levels were assessed.Results: The z-score of the birth weight and IUGR showed significant interactions with postnatal age on cortisol levels; cortisol levels were higher 14 days of birth than those in their peers without IUGR.Conclusion: The adrenal function of newborns with IUGR might be altered from activation to suppression within the first several weeks of life. Longitudinal studies need to address when/how IUGR alters adrenal functions, and how these responses are associated with diseases during adulthood.