Salivary cortisol and cortisone is related to age

Sarah McNally; Julie Park; Helen Shantsila; Silothabo Dliso; Dan Hawcutt; Jo Blair

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ESPE Abstracts (2024) 98 RFC4.2

ESPE2024 Rapid Free Communications Adrenals and HPA Axis 1 (6 abstracts)

Salivary cortisol and cortisone is related to age

Sarah McNally ¹ , Julie Park ¹ , Helen Shantsila ² , Silothabo Dliso ³ , Dan Hawcutt ^1,4 & Jo Blair ^3,5

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¹University of Liverpool, Liverpool, United Kingdom. ²Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom. ³Women's & Children's Health, University of Liverpool, Liverpool, United Kingdom. ⁴NIHR Alder Hey Clinical Research Facility, Alder Hey Children’s Hospital, Liverpool, United Kingdom. ⁵Department of Paediatric Endocrinology, Alder Hey Children’s Hospital, Liverpool, United Kingdom

Background: Cortisol is a hormone critical for good health. Concentrations of cortisol are reported to be increased in people born small for gestational age and obese children. Cortisol excess and deficiency are associated with growth disturbances and changes in blood pressure (BP). Salivary cortisol (SC) and cortisone (SCn) correlate strongly with serum cortisol. In this study we investigated the relationship between SC and SCn, auxological parameters, BP, age and sex in healthy children and young people (CYP).

Methods: CYP aged 5-18 years provided saliva samples using Salivettes (Salimetrics®) 30 minutes after waking and 2-hourly thereafter to bedtime. Samples were analysed by liquid chromatography tandem mass spectrometry. CYP with a family history of inherited adrenal disorders, oral lesions, conditions or medications likely to affect cortisol concentrations were excluded. Age, sex, height and weight were recorded in all participants, and blood pressure (BP) (n = 26) and birth weight in a subset (n = 55). Relationships between these parameters and mean SC and SCn were examined by Pearsons correlation using SPSS software.

Results: 85 (49M) CYP, aged 10.9 ± 3.6 years participated. Clinical characteristics are shown in Table 1.

Table 1: Characteristics of study participants
Characteristic
Mean SC (nmol/L)	3.16 (7.22)
Mean SCn (nmol/L)	7.60 (27.7)
Birth weight SDS	0.10 (4.68)
Height SDS	0.26 (4.79)
BMI SDS	0.24 (5.5)
Diastolic BP (centile)	42.8 (81)
Systolic BP (centile)	67.5 (84)
Data are shown as mean (range)

Both SC and SCn correlated positively with age (P = 0.014 and P < 0.001 for both measures respectively). SC correlated positively with birth weight (P = 0.052), but not SCn. There was no correlation with any other parameters.

Conclusion: To our knowledge, this is the first time the relationship between SC and SCn, and a number of parameters known to be associated with variations in cortisol secretion, has been examined in a cohort of healthy CYP. In contrast to the association of increased cortisol secretion in children born small for gestation age, in a group of CYP of a healthy birth weight, SCn and SC had a positive correlation with birth weight, although not significant. Our data also reported an effect of age on cortisol secretion. The need for age related reference ranges will be tested in larger study cohorts.