Session: FP11-Pediatric Endocrinology
Room 104 (Moscone Center)
Poster Board SAT-597
Design: Children age 3-17y without chronic medical illness including pituitary or adrenal pathologies and/or recent use of systemic glucocorticoids participated in the study. After viewing detailed instructions on salivary sample collection, the subjects/caregivers collected samples on two different dates at their usual bedtime, midnight, and upon waking the following morning.
Results: 183 viable samples have been submitted from 37 children to date: 18 subjects were <8y, 10 were 8-12y, and 9 were 13-17y. Salivary cortisol values (ng/dL) are reported as mean ± SD (range): Bedtime All = 45.3 ± 81.7 (<20-557), <8y = 66.1 ± 117.0 (<20-557), ≥8y = 28.6 ± 25.3 (<20-135); Midnight All = 44.5 ± 84.9 (<20-583), <8y = 73.9 ± 140.3 (<20-583), ≥8y = 30.2 ± 30.3 (<20-135); Morning All = 244.7 ± 261.9 (<20-1790), <8y = 274.0 ± 323.7 (<20-1790), ≥8y = 219.1 ± 193.7 (<20-1100). Caregivers for children <8y noted difficulty in sample collection including emotional distress. For this group, we noted wide cortisol variability and frequently insufficient quantity of saliva (especially at midnight). The bedtime and midnight cortisol levels for all groups were comparable (p-values >0.80). The morning levels were significantly higher than the bedtime and midnight values (p-values <0.01).
Conclusion: These results suggest that adult norms may not apply to the pediatric population. Additionally, bedtime is comparable to midnight measurement, and morning measurement does demonstrate diurnal variation in cortisol secretion. Salivary cortisol measurement by mass spectrometry may be an attractive alternative to the current techniques, though this testing may not be optimal for children <8y.
Nothing to Disclose: RBK, RZS, NKS, TA
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