Interní Med. 2002; 4(6): 280-289

Endokrinologie stárnutí

prof. MUDr. RNDr. Luboslav Stárka DrSc
Endokrinologický ústav, Praha

Keywords: aging, andropause, somatopause, adrenopause, androgens, testosterone, dehydroepiandrosterone.

Published: December 31, 2002  Show citation

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Stárka L. Endokrinologie stárnutí. Interní Med. 2002;4(6):280-289.

Autor podává stručný souhrn nejdůležitějších endokrinních změn, které provázejí stárnutí. U muže je klíčová osa hypotalamus-hypofýza-testes, jejíž snížená výkonnost vede k relativnímu poklesu androgenů. U žen s dozníváním reprodukční funkce ovarií vyhasíná i v nich lokalizovaná tvorba estrogenů, ale i androgenů. Poklesem androgenního zásobení je také oslabován již tak snížený potenciál sekrece růstového hormonu a podobně je tomu i u melatoninu. Specielní roli hraje nadledvinová kůra, která zásobuje organizmus glukokortikoidy v podstatě ve stejné míře jako v období reprodukčního optima, ale nadledvinové androgeny, zejména dehydroepiandrosteron se svou pestrou škálou příznivých účinků na metabolizmus, vykazují výrazný pokles s narůstajícím věkem. Suplementace chybějícími hormony je schopna v pozoruhodné míře zmírnit známky symptomy menopauzy resp. andropauzy, somatopauzy a adrenopauzy, ale bezpečněji v ošetření endokrinosenescence je ve větší šíři zatím zavedena jen léčba estrogeny.

ENDOCRINOLOGY OF AGING

The most important endocrine events typical for aging men are reviewed. The axis hypothalamus-hypophysis-testis and its reduced efficiency, which causes a relative androgen decline in the elderly men, plays a key role. The reduced androgen potential is combined with a decreased secretion of growth hormone as well as the production of melatonin in the pineal gland. A special situation occurs in the adrenal cortex which provides the organism with glucocorticoids in an amount nearly identical as in the optimal reproductive age, whereas the adrenal androgens, esp. dehydroepiandrosterone shows a dramatic decline in the elderly men and so are reduced the benefits elicited by this steroid. The supplementation of the declining hormones is able to ameliorate the multifactorial signs and symptoms of the aging endocrine systems to a considerable degree.

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