Professional Documents
Culture Documents
Aging of The Endocrine System: Ieva B. Akbar
Aging of The Endocrine System: Ieva B. Akbar
ENDOCRINE SYSTEM
IEVA B. AKBAR
INTRODUCTION
Steep Exercise
Hypothalamic peptidergic
and aminergic neurons
Ultrashort loop
Short loop
Long loop
Short loop
End organ hormones
Figure 1. The hypothalamic-pituitary unit and factors that affect its activity, including
inputs from other brain regions and feedback regulatory systems at deveral levels
NOREPINEPHRINE
+ -
CRF _
+
ACTH
Figure 2. The hypothalamic- -
pituitary-adrenal axis.
Inhibitory feedback pathways
are represented by broken line
Corticosteroids
The HPA is considered by many to be the
quint essential neuroendocrine system
because it most clearly portrays complex
interactions between the brain and the
endocrine system to :
1. Maintain homeostasis and control the
response to exogenous and endogenous
stimuli (i.e. stress response)
2. Generate hormonal secretory rhythms
ADRENAL HORMONE
o Physiologic secretion
o Sites of involvement
o Feedback inhibition and peripheral
effect
Investigation of the age-related decline in
episodec GH secretion point to several sites in
the hypothalamic-pituitary axis where there may
be disruption of regulatory mechanism. At the
extrahypothalamic level, there is evidence for
diminished catecholamine neurotransmission
that could cause decreased stimulation of GHRH
or enhanced suppression of somatostatin release.
At the hypothalamic level, a large number of
studies provides convincing evidence that
somatostatin release is increased in aged animals,
and the proportion of the more potent and longer
lasting form, somatostatin-28 increase with age.
It is not clear if the synthesis and/or release of
GHRH decline with age. At the pituitary level,
some studies suggest that the pituitary
responsiveness to GHRH is decreased, possible
due to a loss of functional GHRH receptors.
However, this may be due to the age-associated
decline in pituitary GH content. Evidence from
developmental studies indicates that the
inhibitory influence of somatostatin on pituitary
somatotropes is facilitated during the aging
process. Finally, there is no evidence to indicate
that feedback inhibition, plasma clearance, or the
peripheral actions of GH are significantly altered
in aged animal.
EFFECT OF AGING ON THE
HYPOTHALAMIC-PITUITARY-
TESTICULAR AXIS (HPT)
o Testicular function
o Pituitary and feedback regulation
o Hypothalamic factors :
o GnRH
o Opioids
o Prolactin
There is considerable evidence that normal aging is
accompained by primary testicular failure that is
modest in degree in most individuals. This age-related
testicular failure result in diminished availability of
testosterone and inhibin as well as a decrease in sperm
production. While there is a gonadotropin response to
this testicular failure, there is growing evidence for
subtle defects in hypothalamic-pituitary regulation
that may contribute to the age-related decline in
testicular function. Because of the role that the central
neurotransmitter norepinephrine and opioids play in
regulation of the hypothalamic pituitary axis,
alterations in these central neurotrnsmitters with
aging may contribute to the hypothalamic-pituitary
alterations observed
DISORDERS OF THE
NEUROENDOCRINE SYSTEM
Disorders of the neuroendocrine system
have clinical features related to hormone
excess, hormone deficiency, or local
physical effect from endocrine tumors.
Particularly in the area of hormone
deficiency states. There may be some
challenge to clinical recognition in an
elderly patients population
Symptoms of adrenal, testicular or
pituitary insufficiency tend to be
nonspecific and include weight loss,
fatigue, loss of appetite, muscle wasting,
and impaired sexual function. As any of
these findings may be manifestations of
chronic illness in an older person, it is
understandable that an endocrine cause
for such symptoms, which would be
relatively rare, can be overlooked.
The diagnostic challenge is further
compounded by age-related changes in
neuroendocrine function, as detailed
previously, since decreased growth
hormone and testosterone production
occur with age in the absence of
neuroendocrine disease.
o Hypothalamic-Pituitary Disorders
a. Hypopituitarism
b. Acromegali
c. Gynecomastia
o Testicular disorders
o Disorder of the adrenal gland
a. Glucocorticoid excess
b. Mineralocorticoid excess
c. Adrenal insufficiency
GENERAL AGE-RELATED CHANGE