Abstract
Previous studies have indicated that cortisol hypersecretion and abnormal cortisol responses to dexamethasone (DEX) could be both associated with low levels of plasma melatonin (MT). In this study, the possible relationship between urinary MT excretion (8 PM-8 AM) and the CRF-ACTH-Cortisol axis was investigated. 39 children and adolescents whose weight for age was above the 97th percentile received 2 mg of DEX at 8 PM. Plasma cortisol levels were determined at 8 AM and 5 PM before, and at 8 AM after DEX administration. 15 patients with a normal cortisol cycle (12.1±1.4 and 3.1±0.5 μg/100ml), and levels below 1.0 after DEX, showed a highly significant increase in MT excretion during the night following DEX administration (63.8±5.6 ng/12h vs 33.1±3.0 for the control night, p<.001). In a second group of 14 patients with mean cortisol levels similar at 8 AM and 5 PM (10.7±1.3 and 9.3±1.5), but with a normal cortisol decrease after DEX, nocturnal MT excretion increased from 21.5±2.2 to 34.7±5.6 (p<0.02). A third group of 10 patients with both poor cortisol cycles (16.1±2.5 and 10.8±2.4) and abnormal cortisol suppression after DEX (7.6±2.1), showed no increase in MT excretion (24.2±2.7 and 24.9±3.7). The reciprocal changes in plasma cortisol and MT excretion in obese subjects suggest a relationship between the CRF-ACTH adrenal axis and the pineal gland.
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Lang, U., Theintz, G. & Sizonenko, P. Plasma Cortisol and urinary melatonin in obese patients after a single dose of dexamethasone. Pediatr Res 18, 1214 (1984). https://doi.org/10.1203/00006450-198411000-00079
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DOI: https://doi.org/10.1203/00006450-198411000-00079
