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- Title
Sexual Dimorphism in the Synchrony of Joint Growth Hormone and Cortisol Dynamics in Children with Classic 21-Hydroxylase Deficiency.
- Authors
Charmandari, E.; Pincus, S. M.; Matthews, D. R.; Johnston, A.; Brook, C. G. D.; Hindmarsh, P. C.
- Abstract
In humans, growth hormone (GH) and Cortisol are secreted in a pulsatile fashion and a mutual bidirectional interaction between the GH/insulin-like growth factor (IGF)-I axis and hypothalamic-pituitary-adrenal (HPA) axis has been established. Classic congenital adrenal hyperplasia (CAH) is characterized by a defect in the synthesis of glucocorticoids and often mineralocorticoids, and adrenal hyperandrogenism. In view of the sexually dimorphic pattern in GH secretion, we investigated the GH-cortisol bihormonal secretory dynamics in male and female children with classic CAH. Thirty-eight children with classic 21-hydroxylase deficiency (M: 13, F: 25; age range: 6.1-18.8 yr) were studied prospectively. Serum GH and Cortisol concentrations were determined at 20 min intervals for 24 hours. The irregularity of GH and Cortisol pattern was assessed using approximate entropy (ApEn), a scale- and modelindependent statistic. The synchrony of joint GH-cortisol dynamics was quantified using the cross-ApEn statistic. Cross-correlation analysis of GH and Cortisol concentrations was computed at various time lags covering the 24-h period. There was no gender difference in mean 24-hour serum GH (males vs females: 5.25 ± 4.72 vs 4.44 ± 2.64 mIU/1) or Cortisol (156.2 ± 44.6 vs 172.0 ± 58.5 nmol/1) concentrations. For GH, ApEn values were significantly higher in females (0.66 ± 0.14) than in males (0.53 ± 0.16) (p = 0.009). No difference in Cortisol ApEn values was noted between sexes (0.53 ± 0.21 vs 0.54 ± 0.12). Cross- ApEn values of paired GH-cortisol, with Cortisol leading GH, were significantly higher in females (0.94 ± 0.14) than in males (0.83 ± 0.20) (p = 0.03). These findings suggest that females with classic 21-hydroxylase deficiency have a more irregular pattern of GH secretion and a more asynchronous joint GH and Cortisol dynamics than their male counterparts.
- Publication
Journal of Pediatric Endocrinology & Metabolism, 2003, Vol 16, Issue 8, p1119
- ISSN
0334-018X
- Publication type
Article
- DOI
10.1515/jpem.2003.16.8.1119