Altered control of cortisol secretion in adult men with low birth weight and cardiovascular risk factors

J Clin Endocrinol Metab. 2001 Jan;86(1):245-50. doi: 10.1210/jcem.86.1.7145.


It has been suggested that increased activity of the hypothalamic-pituitary-adrenal axis may link low birth weight with subsequent development of cardiovascular risk factors and disease. Two hundred and five men, aged 66-77 yr, who were born and still live in East Hertfordshire underwent an overnight very low dose (0.25 mg) dexamethasone suppression test followed by a low dose 1-microgram ACTH-(1-24) stimulation test. A 24-h urine sample was collected for analysis of cortisol metabolites by gas chromatography/electron impact mass spectrometry. Men with lower birth weight had enhanced responses of plasma cortisol to ACTH-(1-24) (P = 0.03), increased total urinary cortisol metabolite excretion (after adjustment for confounding effects of increased obesity and lean body mass in high birth weight men; P = 0.04), but no difference in plasma cortisol after dexamethasone. Features of the metabolic syndrome were independently associated with enhanced adrenal responsiveness to ACTH-(1-24) (raised blood pressure, P = 0.02; glucose intolerance, P = 0.09; hypertriglyceridemia, P = 0.02), with trends to increased urinary cortisol metabolite excretion, but not with differences in plasma cortisol after dexamethasone. Men with low birth weight and/or the metabolic syndrome have increased activity of the hypothalamic-pituitary-adrenal axis. This may be an important mechanism underpinning the effects of events in early life on later cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Birth Weight
  • Cardiovascular Diseases / etiology*
  • Cohort Studies
  • Humans
  • Hydrocortisone / metabolism*
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Male
  • Metabolic Diseases / complications
  • Prognosis
  • Risk Factors


  • Hydrocortisone