Bibian van der Voorn

17 PRETERM GLUCOCORTICOID PROGRAMMING Huysman [103], 2000 21 <30 wks, sick and healthy 4 days Basal cortisol and 17-OHP, and ACTH-stimulated (0.5 μg) cortisol – 277±144 d 753±250 d – n.a. ↓ cortisol and ↑ 17-OHP/cortisol ratio in ventilated compared to nonventilated infants Bolt [43], 2002 24 <33 wks, healthy Group 1: <30 wks (n = 13) Group 2: 30–33 wks (n = 11) 5–10 days Basal cortisol, 17-OHP and E, and ACTH- stimulated (1 μg/kg) cortisol and 17-OHP Group 1 178±15 a 515±33 a – n.a. ↑ E and 17-OHP/cortisol ratio in group 1 compared to group 2 Group 2 250±42 a 733±89 a Kajantie [9], 2006 44 <1,000 g, sick and healthy 1.6±1.1 d days Basal and ACTH-stimulated (0.06 μg/kg) cortisol – 119 (55–300) e 261 (176–456) e – n.a. – CRH test Rizvi [35], 1992 10 27.3±5 d wks, sick 7.5±9.4 d days Basal and CRH-stimulated (1 μg/kg) cortisol and ACTH g 275 f No rise in 3/10 cases – No rise in 3/10 cases – Ng [38], 1997 14 <32 wks, healthy 7 and 14 days Basal and CRH-stimulated (1 μg/kg) cortisol and ACTH – 396±67 a 647±62 a 5.7±0.6 a 11.9±2.1 a – Bolt [36], 2002 29 <32 wks, healthy 7–21 days Study 1 (n = 13): basal and CRH-stimulated (1 μg/kg) cortisol and ACTH Study 2 (n = 16): basal and CRH-stimulated (1 μg/kg vs. CRH 2 μg/kg vs. placebo) cortisol and ACTH Study 1 350±115 d 582±201 d 6.9±2.1 d 11.6±5.1 d (<9 in 5/13 cases) – Study 2: CRH 1 μg/kg 256±120 d 509±167 d 6.1±4.0 d 10.5±4.4 d (<9 in 2/5 cases) Study 2: CRH 2 μg/kg 330±154 d 815±212 d 4.5±1.5 d 11.3±4.3 d (<9 in 2/6 cases) Ng [39], 2002 137 <1,500 g, sick and healthy 7 and 14 days Basal and CRH-stimulated (1 μg/kg) cortisol and ACTH 7 days g 286 f 513 f 5.5 f 10.4 f – 14 days g 237 f 509 f 7.1 f 12.7 f Multiple stimulation tests Hanna [34], 1993 17 26.1 wks, sick 2–7 days Basal and CRH-stimulated (1 μg/kg) cortisol and ACTH, and ACTH-stimulated cortisol CRH test 349±58 a 569±60 a 6.0±1.8 a 9.6±1.8 a – ACTH test 604±131 a,h 883±137 a – – Ford [33], 1997 9 25.7±1.0 d wks, sick 19.9±8.0 d days Basal cortisol and ACTH; cortisol, ACTH and S after metyrapone 40 mg/kg; ACTH-stimulated (40 μg/kg) cortisol; CRH- stimulated (1 μg/kg) cortisol and ACTH g 513±108 a (<414 in 2/9 cases) 684±48 a after ACTH – 5.0±1.7 a after CRH S >7.0 μg/dL after metyrapone in 9/9 cases 17-OHP = 17-Hydroxyprogesterone; ACTH = adrenocorticotropin; B = corticosterone; CBG = cortisol-binding globulin; DOC = deoxycorticosterone; DHEA(S) = dehydroepiandrosterone (sulphate); E = cortisone; n.a. = not applicable; S = 11-deoxycortisol. a Mean ± SEM; b median (range); c mean; d mean ± SD; e geometric mean (interquartile range); f median; g data of infants without, or prior to, dexamethasone treatment; h  the ACTH test was conducted 2 h after the CRH test; therefore, at the start of the ACTH test the basal cortisol level was already 604±131 nmol/L.