Altered control of cortisol secretion in adult men with low birth weight and cardiovascular risk factors.
It has been suggested that increased activity of the hypothalamic-pituitary-adrenal axis may link low birth weight with subsequent development of cardiovascular risk factors and disease. Two hundred and five men, aged 66-77 yr, who were born and still live in East Hertfordshire underwent an overnight very low dose (0.25 mg) dexamethasone suppression test followed by a low dose 1-microgram ACTH-(1-24) stimulation test. A 24-h urine sample was collected for analysis of cortisol metabolites by gas chromatography/electron impact mass spectrometry. Men with lower birth weight had enhanced responses of plasma cortisol to ACTH-(1-24) (P = 0.03), increased total urinary cortisol metabolite excretion (after adjustment for confounding effects of increased obesity and lean body mass in high birth weight men; P = 0.04), but no difference in plasma cortisol after dexamethasone. Features of the metabolic syndrome were independently associated with enhanced adrenal responsiveness to ACTH-(1-24) (raised blood pressure, P = 0.02; glucose intolerance, P = 0.09; hypertriglyceridemia, P = 0.02), with trends to increased urinary cortisol metabolite excretion, but not with differences in plasma cortisol after dexamethasone. Men with low birth weight and/or the metabolic syndrome have increased activity of the hypothalamic-pituitary-adrenal axis. This may be an important mechanism underpinning the effects of events in early life on later cardiovascular disease.
Reynolds
R M
RM
Medical Research Council Environmental Epidemiology Unit, University of Southampton, United Kingdom. r.reynolds@ed.ac.uk
Walker
B R
BR
Syddall
H E
HE
Andrew
R
R
Wood
P J
PJ
Whorwood
C B
CB
Phillips
D I
DI
D000368:Aged; D001724:Birth Weight; D002318:Cardiovascular Diseases / Q000209:etiology*; D015331:Cohort Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008659:Metabolic Diseases / Q000150:complications; D011379:Prognosis; D012307:Risk Factors
D006854:Hydrocortisone