ABSTRACT
OBJECTIVE: The clinical relevance of lower basal cortisol levels in children with asthma is unclear. We compared the salivary cortisol response after a standardized exercise test in children with asthma versus the salivary cortisol response in healthy children. METHODS: Nineteen prepubertal children with asthma and 20 prepubertal healthy children performed a standardized exercise test twice. Salivary cortisol levels were determined before exercise and immediately and 15 min after exercise. Morning salivary cortisol levels were determined from saliva collected at home. RESULTS: Salivary cortisol levels increased in 84.2% of the healthy children compared to 35.0% in children with asthma after the 20-m shuttle-run test. Median increase in salivary cortisol levels was 200.3% [95% confidence interval (CI), 141.8-346.1] in healthy children compared to 89.8% (95% CI, 56.9-181.6) in children with asthma. The response was not related to the morning salivary cortisol level or maintenance dose of inhaled corticosteroids. The mean time to exhaustion of both shuttle-run tests was significantly shorter in children with asthma (mean difference 1.4 min; 95% CI, 0.7-2.3). None of the children had to stop because of dyspnea. CONCLUSION: Our study demonstrates that children with asthma using a maintenance dose of inhaled corticosteroids (ICS) have an attenuated salivary cortisol response compared with healthy children.
Subject(s)
Asthma/metabolism , Exercise/physiology , Hydrocortisone/metabolism , Saliva/metabolism , Child , Circadian Rhythm , Down-Regulation , Exercise Test , Female , Humans , MaleABSTRACT
OBJECTIVE: To determine the feasibility of non-invasive evaluation of adrenal response in healthy prepubertal children by standardized exercise tests. METHODS: On separate occasions, healthy prepubertal children performed a submaximal cycling test, a maximal cycling test, and a 20-m shuttle-run test. Salivary cortisol levels were determined before exercise, and 1 and 15 min after exercise. RESULTS: Immediately after cessation of the cycling and shuttle-run tests, salivary cortisol levels remained unchanged or decreased. Fifteen minutes after the shuttle-run test, salivary cortisol levels increased significantly. This increase in salivary cortisol levels was not observed 15 min after the cessation of the cycling tests. CONCLUSION: The results of this study demonstrate a different response in salivary cortisol levels after standardized cycling and running tests in prepubertal children. The increase in salivary cortisol levels found after a short standardized running test suggests that this may be a practical non-invasive method for evaluating adrenal response in healthy prepubertal children.
