SynthesisBiology of sex differences2017
Is HPA axis reactivity in childhood gender-specific? A systematic review.
Synthesis in Biology of sex differences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Gender differences in the effects of economic inequality on mental conditions: a multivariate meta-analysis of Gini index and relative income position in high-income OECD countries.Frontiers in psychiatry · 2026Pooled it
- Mediators and moderators in the relationship between maternal childhood adversity and children's emotional and behavioural development: a systematic review and meta-analysis.Psychological medicine · 2022Pooled it
- Influence of Regular Physical Activity and Fitness on Stress Reactivity as Measured with the Trier Social Stress Test Protocol: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2018Pooled it
- Oral Lorazepam is not Superior to Placebo for Lowering Stress in Children Before Digestive Endoscopy: A Double-Blind, Randomized, Controlled Trial.Paediatric drugs · 2019Trial
- Adrenal Biomarkers of Stress in Transgender and Gender-Diverse Adolescents.Developmental psychobiology · 2026Article
- Adolescent binge drinking causes sex-specific deficits in behavioral reactivity, endocrine recovery from stress and altered expression of hypothalamic KCC2 in males.Psychopharmacology · 2026Article
- From Basic Psychological Need Frustration to Stress Responses: Examining how Bullying Victimization Sensitizes Daily-Life Experiences in Adolescence.Journal of youth and adolescence · 2026Article
- Adverse childhood experiences, bullying victimization and risk of suicidal ideation among adolescents: evidence from a longitudinal cohort.BMC public health · 2026Article
- Sex and age differences in cortisol levels during glucagon stimulation test in children.BMC pediatrics · 2025Article
- Gender differences of neurometabolic and neuroendocrine alternations and its lateralization in adolescents with major depressive disorder.BMC psychiatry · 2024Article
- Hippocampal and limbic microstructure changes associated with stress across the lifespan: a UK biobank study.Scientific reports · 2024Article
- Sexual dimorphism in anxiety is programmed in-utero by sex-steroids: Proof of concept using a disease-model and stress responses to COVID pandemic.Psychiatry research · 2024Article
- Sex differences in stress responses among underrepresented minority adolescents at risk for substance use disorder.International journal of psychophysiology : official journal of the International Organization of Psychophysiology · 2023Article
- Protocol and biomarker strategy for a multi-site randomized controlled trial examining biological mechanisms and dosing of active music engagement in children with acute lymphoblastic leukemia and lymphoma and parents.BMC complementary medicine and therapies · 2023Article
- The Perceived Stress Scale for Kids (PeSSKi): Initial development of a brief measure for children aged 7-11 years.Stress and health : journal of the International Society for the Investigation of Stress · 2023Article
- Adverse Childhood Experiences and Pathways to Violent Behavior for Women and Men.Journal of interpersonal violence · 2023Article
- Difference in Hair Cortisol Concentrations between Obese and Non-Obese Children and Adolescents: A Systematic Review.Children (Basel, Switzerland) · 2022Review
- Maternal Stress, Early Life Factors and Infant Salivary Cortisol Levels.Children (Basel, Switzerland) · 2022Article
- Early life adversity and males: Biology, behavior, and implications for fathers' parenting.Neuroscience and biobehavioral reviews · 2022Review
- Do Trajectories of Sensation Seeking Vary by Sex and Child Maltreatment Subtypes?Journal of interpersonal violence · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn adults, hypothalamus-pituitary-adrenal (HPA) axis activity shows sexual dimorphism, and this is thought to be a mechanism underlying sex-specific disease incidence. Evidence is scarce on whether these sex differences are also present in childhood. In a meta-analysis, we recently found that basal (non-stimulated) cortisol in saliva and free cortisol in 24-h urine follow sex-specific patterns. We explored whether these findings could be extended with sex differences in HPA axis reactivity.
methodsFrom inception to January 2016, PubMed and EMBASE.com were searched for studies that assessed HPA axis reactivity in healthy girls and boys aged ≤18 years. Articles were systematically assessed and reported in the categories: (1) diurnal rhythm, (2) cortisol awakening response (CAR), (3) protocolled social stress tests similar or equal to the Trier Social Stress Test for children (TSST-C), (4) pharmacological (ACTH and CRH) stress tests, and (5) miscellaneous stress tests.
resultsTwo independent assessors selected 109 out of 6158 records for full-text screening, of which 81 studies (with a total of 14,591 subjects) were included. Studies showed that girls had a tendency towards a more variable diurnal rhythm (12 out of 29 studies), a higher CAR (8 out of 18 studies), and a stronger cortisol response to social stress tests (9 out of 21 studies). We found no evidence for sex differences in cortisol response after a pharmacological challenge or to miscellaneous stress tests. DISCUSSION: Sex differences in HPA axis reactivity appear to be present in childhood, although evidence is not unequivocal. For a better evaluation of sex differences in HPA axis reactivity, standardization of protocols and reports of stress tests is warranted.
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