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Cited by 34Adrenal Hormones and DisordersStress Responses and CortisolHormonal and reproductive studies

Deconvolution analysis of 24‐h serum cortisol profiles informs the amount and distribution of hydrocortisone replacement therapy

Peters, Catherine J., Hill, Nathan, Dattani, Mehul T., Charmandari, Evangelia, Matthews, David R., Hindmarsh, Peter C.·2013·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2012.04502.x
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Abstract

Summary: Background: Hydrocortisone therapy is based on a dosing regimen derived from estimates of cortisol secretion, but little is known of how the dose should be distributed throughout the 24 h. We have used deconvolution analysis of 24‐h serum cortisol profiles to determine 24‐h cortisol secretion and distribution to inform hydrocortisone dosing schedules in young children and older adults. Methods: Twenty four hour serum cortisol profiles from 80 adults (41 men, aged 60–74 years) and 29 children (24 boys, aged 5–9 years) were subject to deconvolution analysis using an 80‐min half‐life to ascertain total cortisol secretion and distribution throughout the 24‐h period. Results: Mean daily cortisol secretion was similar between adults (6·3 mg/m 2 body surface area/day, range 5·1–9·3) and children (8·0 mg/m 2 body surface area/day, range 5·3–12·0). Peak serum cortisol concentration was higher in children compared with adults, whereas nadir serum cortisol concentrations were similar. Timing of the peak serum cortisol concentration was similar (07·05–07·25), whereas that of the nadir concentration occurred later in adults (midnight) compared with children (22·48) (P = 0·003). Children had the highest percentage of cortisol secretion between 06·00 and 12·00 (38·4%), whereas in adults this took place between midnight and 06·00 (45·2%). Conclusions: These observations suggest that the daily hydrocortisone replacement dose should be equivalent on average to 6·3 mg/m 2 body surface area/day in adults and 8·0 mg/m 2 body surface area/day in children. Differences in distribution of the total daily dose between older adults and young children need to be taken into account when using a three or four times per day dosing regimen.

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Authors
Peters, C. J., Hill, N., Dattani, M. T., Charmandari, E., Matthews, D. R., & Hindmarsh, P. C.
Affiliations
  • Great Ormond Street Hospital (GB)
  • Oxford Centre for Diabetes, Endocrinology and Metabolism (GB)
  • National and Kapodistrian University of Athens (GR)
Corresponding author
Hindmarsh, Peter C.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2013-01-25
Volume
78
Issue
3
Pages
347-351
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2012.04502.x
OpenAlex
W2081048661
Cited by
34
References
21
Citations by year
2026: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 4
FWCI
1.54
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
National Institute for Health and Care Research (NF-SI-0508-10272)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
hydrocortisone replacement, cortisol secretion, deconvolution, dosing regimen, children, older adults, adrenal insufficiency
MeSH terms
Aged, Child, Child, Preschool, Drug Administration Schedule, Female, Humans, Hydrocortisone, Male, Middle Aged, In Vitro Techniques

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