Interpretation of Cortisol Concentrations and Reference Intervals from the CALIPER Database

[摘要] To the Editor:Measuring chronic stress and its effects is particularly challenging in the pediatric population. Infants and children are more vulnerable to the effects of chronic stress because the brain structures associated with stress regulation (hypothalamic–pituitary–adrenalaxis, autonomic nervous system, limbic system) are still developing and thus susceptible to allostatic load. In early childhood, these effects are often unmasked when diurnal cortisol patterns are measured over successive days, or when baseline cortisol concentrations are compared with those obtained after exposure to psychological stressors, physiological tests, or pharmacologic interventions (the insulin tolerance test, the adrenocorticotropic hormone stimulation test, the dexamethasone suppression test, and others).The investigators reporting from the CALIPER1 (Canadian Laboratory Initiative on Pediatric Reference Intervals) program database (1–3) are laudably addressing the need for normative levels and reference intervals (RIs) for serum biomarkers in healthy children and adolescents. Nonetheless, there appear to be discrepancies in the age-associated concentrations of cortisol reported for the sampling …

[学科分类] 过敏症与临床免疫学