Morning Salivary Cortisol in Young Children: Reference Values and the Effects of Age, Sex, and Acute Bronchiolitis

• Published in: The Journal of pediatrics Vol. 184; pp. 193 - 198.e3
• Main Authors: Rolfsjord, Leif Bjarte, MD, Bakkeheim, Egil, M.D, PhD, Berents, Teresa Løvold, MD, Alm, Johan, MD, PhD, Skjerven, Håvard Ove, MD, PhD, Carlsen, Kai-Håkon, MD, PhD, Mowinckel, Petter, MSc, Sjöbeck, Ann-Christine, BSc, Carlsen, Karin Cecilie Lødrup, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2017
• Subjects: Acute Disease; adrenocortical function; Age Factors; allergic disease; allergic rhinitis; asthma; Bronchiolitis - metabolism; Child, Preschool; Circadian Rhythm; Cohort Studies; Female; health-related quality of life; Humans; Hydrocortisone - analysis; Hydrocortisone - biosynthesis; Infant; infants; Male; Medicin och hälsovetenskap; morning salivary cortisol; Pediatrics; Reference Values; Saliva - chemistry; Severity of Illness Index; Sex Factors; stress; toddlers; morning salivary cortisol; stress; toddlers; adrenocortical function; infants; Respiratory syncytial virus; RSV; asthma; health-related quality of life; allergic rhinitis; allergic disease
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2017.01.064

Objective To identify morning salivary cortisol reference values in infancy and at 2 years of age and to investigate the influence of age, sex and acute bronchiolitis. Study design In this South-East Norwegian cohort study, 308 children hospitalized with moderate to severe acute bronchiolitis in infancy in 2010-2011 were compared with 223 healthy controls included in 2012 by measuring morning salivary cortisol levels at inclusion and at 2 years of age. Samples were collected shortly after awakening after 6 am . The influences of age, sex, and acute bronchiolitis were assessed by regression analysis. Results In infancy, cortisol values were higher in acute bronchiolitis, with an age- and sex-adjusted weighted mean group difference of 13.9 nmol/L (95% CI 8.1-19.7; P  < .0001). The median level in reference group was 23.7 nmol/L (95% CI 9.7-119.6). At 2 years of age, sex but not inclusion groups differed, with significantly higher values in girls. The weighted mean of all boys' cortisol levels was 32.4 nmol/L, (95% CI 30.5-34.3), and all girls' levels were 36.9 nmol/L (95% CI 34.7-39.2; P  < .003). Conclusions Salivary cortisol levels were higher at 2 years of age than in infancy in the reference group, were higher in girls than in boys at 2 years of age, and were higher in infants at the time of acute bronchiolitis than in healthy infants. Trial registration ClinicalTrials.gov : NCT00817466