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Development of 24-hour rhythms in cortisol secretion across infancy: a systematic review and meta-analysis of individual participant data
Group of Circadian Medicine, Department of Cell and Chemical Biology, Leiden University Medical Center, the Netherlands.
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.
Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, Pediatric Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
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2025 (Engelska)Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 110, nr 2, s. e515-e524Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

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: 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: 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: 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.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2025. Vol. 110, nr 2, s. e515-e524
Nyckelord [en]
Adrenal cortex hormones, adrenal insufficiency, biological clocks, circadian rhythm, cortisol, endocrinology, hydrocortisone, infant, pediatrics
Nationell ämneskategori
Pediatrik
Identifikatorer
URN: urn:nbn:se:oru:diva-115717DOI: 10.1210/clinem/dgae590ISI: 001310220700001PubMedID: 39207206Scopus ID: 2-s2.0-85216569389OAI: oai:DiVA.org:oru-115717DiVA, id: diva2:1894078
Anmärkning

This study was supported by the International Fund Congenital Adrenal Hyperplasia (to MJJF). LK was partly supported by a VENI grant (2020-09150161910128 to LK) from the Netherlands Organization for Health Research and Development (ZonMw) and the BioClock Consortium (project number 1292.19.0777to LK and AK) funded by the research programme NWA-ORC of the Dutch Research Council (NWO).

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Tillgänglig från: 2024-09-02 Skapad: 2024-09-02 Senast uppdaterad: 2026-01-23Bibliografiskt granskad

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Cao, Yang

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Journal of Clinical Endocrinology and Metabolism
Pediatrik

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