Development of 24-hour rhythms in cortisol secretion across infancy: a systematic review and meta-analysis of individual participant data.

adrenal cortex hormones adrenal insufficiency biological clocks circadian rhythm cortisol endocrinology hydrocortisone infant pediatrics

Journal

The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362

Informations de publication

Date de publication:
29 Aug 2024
Historique:
received: 05 06 2024
revised: 07 08 2024
accepted: 28 08 2024
medline: 31 8 2024
pubmed: 31 8 2024
entrez: 29 8 2024
Statut: aheadofprint

Résumé

In adults, cortisol levels show a pronounced 24-hour rhythm with a peak in the early morning. It is unknown at what age this early-morning peak in cortisol emerges during infancy, hampering the establishment of optimal dosing regimens for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency. Therefore, we aimed to characterize daily variation in salivary cortisol concentration across the first year of life. We conducted a systematic review followed by an individual participant data meta-analysis of studies reporting on spontaneous (i.e., not stress induced) salivary cortisol concentrations in healthy infants aged 0-1 year. A one-stage approach using linear mixed-effects modelling was used to determine the interaction between age and time of day on cortisol concentrations. Through the systematic review, 54 eligible publications were identified, reporting on 29,177 cortisol observations. Individual participant data were obtained from 15 study cohorts, combining 17,079 cortisol measurements from 1,904 infants. The morning/evening cortisol ratio increased significantly from 1.7 (95% CI: 1.3-2.1) at birth to 3.7 (95% CI: 3.0-4.5) at 6-9 months (p < 0.0001). Cosinor analysis using all available data revealed the gradual emergence of a 24-hour rhythm during infancy. The early-morning peak in cortisol secretion gradually emerges from birth onwards to form a stable morning/evening ratio from age 6-9 months. This might have implications for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency.

Sections du résumé

BACKGROUND BACKGROUND
In adults, cortisol levels show a pronounced 24-hour rhythm with a peak in the early morning. It is unknown at what age this early-morning peak in cortisol emerges during infancy, hampering the establishment of optimal dosing regimens for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency. Therefore, we aimed to characterize daily variation in salivary cortisol concentration across the first year of life.
METHODS METHODS
We conducted a systematic review followed by an individual participant data meta-analysis of studies reporting on spontaneous (i.e., not stress induced) salivary cortisol concentrations in healthy infants aged 0-1 year. A one-stage approach using linear mixed-effects modelling was used to determine the interaction between age and time of day on cortisol concentrations.
FINDINGS RESULTS
Through the systematic review, 54 eligible publications were identified, reporting on 29,177 cortisol observations. Individual participant data were obtained from 15 study cohorts, combining 17,079 cortisol measurements from 1,904 infants. The morning/evening cortisol ratio increased significantly from 1.7 (95% CI: 1.3-2.1) at birth to 3.7 (95% CI: 3.0-4.5) at 6-9 months (p < 0.0001). Cosinor analysis using all available data revealed the gradual emergence of a 24-hour rhythm during infancy.
INTERPRETATION CONCLUSIONS
The early-morning peak in cortisol secretion gradually emerges from birth onwards to form a stable morning/evening ratio from age 6-9 months. This might have implications for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency.

Identifiants

DOI: 10.1210/clinem/dgae590 PMID: 39207206
pubmed: 39207206
pii: 7745047
doi: 10.1210/clinem/dgae590
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.

Auteurs

Laura Kervezee (L)

Group of Circadian Medicine, Department of Cell and Chemical Biology, Leiden University Medical Center, the Netherlands.
ORCID: 0000-0002-6062-9164

Michelle Romijn (M)

Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands.

Kirsten N G van de Weijer (KNG)

Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.

Britney S J Chen (BSJ)

Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.

George L Burchell (GL)

Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Marieke S Tollenaar (MS)

Department of Developmental Psychology, Behavioural Science Institute, Radboud University, 6500 HB, Nijmegen, The Netherlands.
Department of Clinical Psychology, Institute of Psychology, Leiden University, 2333 AK, Leiden, The Netherlands.

Marcela Tamayo-Ortiz (M)

Department of Environmental Health Sciences, Columbia Center for Children's Environmental Health, Columbia University Mailman School of Public Health, New York, USA.

Lauren E Philbrook (LE)

Department of Psychological and Brain Sciences, Colgate University, 13 Oak Drive, Hamilton, NY 13346, USA.
Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16801, USA.

Carolina de Weerth (C)

Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.

Yang Cao (Y)

Clinical Epidemiology and Biostatistics, Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro 70185, Sweden.
Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm 17177, Sweden.

Joost Rotteveel (J)

Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
ORCID: 0000-0001-7635-564X

Rina D Eiden (RD)

Department of Psychology and the Social Science Research Institute, The Pennsylvania State University, University Park, Pennsylvania, 16801, USA.

Rima Azar (R)

Psychobiology of Stress & Health Lab, Psychology Department, Mount Allison University, New Brunswick, Canada.

Nicole R Bush (NR)

Departments of Psychiatry and Pediatrics, University of California, San Francisco (UCSF), USA.

Adina Chis (A)

Department of Molecular Sciences, "Iuliu Hațieganu" University of Medicine and Pharmacy, 6 Louis Pasteur St., 400349 Cluj-Napoca, Romania.
Cognitive Neuroscience Laboratory, Babes-Bolyai University, 30 Fântânele St., 400294, Cluj-Napoca, Romania.

Grazyna Kmita (G)

Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland.
Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland.

Melissa W Clearfield (MW)

Department of Psychology, Whitman College, WA, USA.

Roseriet Beijers (R)

Department of Developmental Psychology, Behavioral Science Institute, Radboud University, 6500 HB Nijmegen, The Netherlands.
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.

Michael Gröschl (M)

Celerion Switzerland AG, Switzerland.

Stefan A Wudy (SA)

Paediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, D-95392 Giessen, Germany.

Andries Kalsbeek (A)

Amsterdam UMC, University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands.
Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, The Netherlands.
Amsterdam UMC, University of Amsterdam, Laboratory of Endocrinology, Department of Laboratory Medicine, Amsterdam, The Netherlands.
Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Metabolism and Nutrition, Amsterdam, The Netherlands.
Amsterdam Neuroscience, Cellular and Molecular Mechanisms, Amsterdam, The Netherlands.

Evalotte Mörelius (E)

Department of Health, Medicine and Caring Sciences, Linköping University, 58185 Linköping, Sweden.
School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6027, Australia.

Martijn J J Finken (MJJ)

Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands.
ORCID: 0000-0002-6589-9788

Classifications MeSH