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203: Reproduction and endocrinology > T1 L12 :EFFECTS OF AGE AND DIETON ENDOCRINE FUNCTION > Flashcards

T1 L12 :EFFECTS OF AGE AND DIETON ENDOCRINE FUNCTION Flashcards

1
Q

what are the phenotypic effects of ageing

5marks

A
  • Increase fat mass, decreased visceral fat
  • Sarcopaenia
  • Decreased Bone mineral density
  • Decreased QOL / mood
  • increased risk cardiovascular disease
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2
Q

what are the 2 main features of ageing

A

Hypogonadism / growth hormone deficiency / aging

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3
Q

what are the nutritional stats with age ( Weight, lean body mass and Diet )

A

1- Increase from mid-30s
stabalise 50 – 70

2-Decrease by 6-8% / decade from mid-30s

3-Diet - Trend towards decrease in the intake total energy & protein with increasing age

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4
Q

what occurs to your insulin and glucose levels with age

A

increased insulin and glucose conc with age.

More insulin resistance and so less peripheral glucose uptake

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5
Q

What happens to metabolic syndrome with age

A

Prevalence Increases

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6
Q

what are the 2 main areas of gonadal axis research

A

Menopause

Testosterone

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7
Q

what is menopause

A

Ovarian failure

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8
Q

what occurs to estrogen levels during menopause

pre and post

and what happens to E2 LH and FSH

A

Pre-menopausal: cycling

Post-menopausal: very low constant levels:

-decreased E2, but increased LH and FSH

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9
Q

what are the symptoms of menopause

and what is the mean duration

A

Hot flushes, night sweats

Median duration of menopausal symptoms 7 years

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10
Q

what causes morbidity in menopause

A

increased osteoporosis

increased CHD

increased sexual dysfunction

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11
Q

what is HRT

A

Hormone replacement therapy - used as a treatment of symptoms of disorders associated with oestrogen deficiency like osteoporosis )

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12
Q

what are the benefits of POST-MENOPAUSAL HRT

A

decreased osteoporosis and therefore fracture risk

Decreases menopausal symptoms

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13
Q

what are the risks of POST-MENOPAUSAL HRT

A

-increase in venous thrombo-embolism

-Increase in breast Ca (small)
esp > 5 years

  • Increase in endometrial Ca
  • –if use unopposed E2
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14
Q

what occurs in the male gonadal axis

and give a rough statistic of what happens at 75 years compared with 25

A

a gradual decrease in testosterone associated with increasing age

at 75 years 2/3rds that of @ 25 years

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15
Q

what are the effects of low testosterone in men

A

poor libido

increase in osteoporosis

decrease in muscle strength

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16
Q

what are the effects of testosterone treatment on bone

A

increase in bone mineral density of hypogonadal but bisphosphonates work independent of the androgen status

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17
Q

what happens to the body composition with the male gonadal axis with testosterone treatment

advantages

A

decrease fat mass

increase in lean mass

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18
Q

what is there little to no evidence of testosterone treatment improving

A

Atherosclerosis

sexual function

cognitive function

Mood/quality of life

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19
Q

what does weight loss improve

A

levels of testosterone

20
Q

what happens to the GH-IGF-I axis as you age

A

GH and IGF-I decreases with age

but still wide variation

21
Q

what does GH treatment do to body composition

A
  • increases  lean body mass

- decreases fat mass

22
Q

what doesn’t change significantly with GH treatment

A
  • Bone mineral density

- Lipids

23
Q

what are the risks with GH treatment

A
  • Cancer I increased IGF-I assoc with non-smoking cancers-prostate, coon, breast
  • Increase in T2 DM
24
Q

what are the side effects of GH treatment

A
  • Soft tissue oedema
  • Arthralgias
  • Carpal tunnel syndrome
25
what happens with cortisol as you age
there is an increase in the levels- trough levels also increase phase advance of diurnal rhythm (Troughs and peaks occur earlier)
26
what is the Sapolsky's glucocorticoid cascade hypothesis
- decrease in hippocampal glucocorticoid & mineralocorticoid receptors - decrease sensitivity to glucocorticoid negative feedback - increase in glucocorticoids leading to hippo campal neurons vulnerable to damage ‘feed forward cascade’
27
what happens to DHEAs with age
they decrease with age (helps to protect against CHD) therefore a low DHEA: low]:cortisol ratio found in cancer, inflammatory diseases, T2DM, CV disease
28
what does DHEA have no evidence of effect on
- body comp - physical performance - Insulin sensitivity
29
what does increasing age do to thyroid hormone biomarkers
increase in TSH T4 same decrease in T3 decrease in peripheral T4-T3 conversion
30
what does starvation do to gluc-insulin levels
It decreases them and increases insulin sensitivity
31
what is Leptin produced by
It's produced by white adipose tissue
32
what does starvation signal do to leptin and to hypothalamus
It signals energy availability Decrease leptin- Increase food uptake and decreased energy expenditure decreased leptin leads to decrease fertility
33
what does starvation do to oestrogen and testosterone
It decreases LH and FSH and oestrogen and testosterone it decreases fertility an increases hypothalamic amenorrhoea
34
what is the evidence of metabolism and reproduction
OB Ob mouse was hyperphagic and obese - had low gonads - infertile - didn't mature sexually
35
what happened to gonads and weight when obob mouse was given Leptin (+puberty and fertility)
Reduced obesity restore GN secretion induce puberty restore fertility
36
what is amenorrhoea
an abnormal absence of menstruation.
37
is amenorrhoea due to the hypothalamus | if so why
yes Sometimes the hypothalamus stops producing GnRH, which, in turn, will reduce the amount of other hormones produced (FSH, LH, and estrogen). Ovulation and menstruation stop, resulting in infertility.
38
what is kisspeptin
A GnRH secretagogue
39
what does kisspeptin neurons do
KISS1 neurons highly responsive to oestrogen, implicated in both + and – central feedback of sex steroids on GnRH production Metabolic influences on reproduction mediated by leptin via the kisspeptin system Puberty Reproduction
40
what does leptin do to kisspeptin
Leptin promotes GnRH function via an indirect action on forebrain neurons. We tested whether leptin deficiency or leptin resistance due to a high-fat diet (HFD) can regulate the potent reproductive neuropeptide kisspeptin.
41
what does starvation do to the GH/IGF axis
GH resistance increased GH and a decrease in IGF-I due to downregulation of hepatic GH receptor
42
is the effect of GH/IGF axis reversible
yes with re-feeding
43
what does starvation do to cortisol levels
Pulsatile Rhythm
44
what does starvation do to thyroid biomarker levels
It decreases TSH and T4 leading to less conversion to T3 but more to rT3 (inactive form)
45
consequences of starvation on thyroid gland
- Lower basal metabolic rate | - Conserve energy

203: Reproduction and endocrinology (53 decks)

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