T1 L15: Effects of age and diet on endocrine function Flashcards
How does our weight change as we age?
There is a rise is weight in mid-30’s and then it steadies off between 50-70
How does our insulin resistance change as we age?
Insulin resistance increases and peripheral glucose uptake decreases
The prevalence of metabolic syndromes increases with age
What is metabolic syndrome?
A constellation of closely associated CV risk factors for which insulin resistance is the underlying pathophysiological cause
Includes: Visceral obesity Dyslipidaemia Hyperglycaemia Hypertension
What is the gonadal axia?
Includes the pituitary gland, testis/ovaries and all the hormones in between like:
- Testosterone
- Oestrogens
- LL
- FSH
- Progesterone
What is menopause?
Ovarian failure that results in a contestant low level of oestrogen and a high level of LH and FSH
What are some symptoms of menopause?
Hot flushes and night sweats.
Causes an increased risk of osteoporosis, Coronary heart disease, and sexual dysfunction
Symptoms last for about 7 years
What is the age of menopause?
50 -+2
What are the benefits of hormone replacement therapy post-menopause?
Reduced menopausal symptoms
Decreased risk of osteoporosis and therefore fracture risk
What are the risks of hormone replacement therapy post-menopause?
- DVT
- Breast cancer especially when used for more than 5 years
- Endometrial cancer if unopposed E2 is used
How does the male gonadal axis change as they age?
- There is a gradual decrease of testosterone
- Poor association between libido/erectile dysfunction/testosterone
Clinical hypogonadism causes decreased sexual function, increased risk of osteoporosis, and decreased muscle strength
What are the benefits of using testosterone for older men?
- Small improvement in sexual function
- Increased mineral density of bones
- Increased lean body mass
- Decreased fat mass
- Increased muscle strength
Little/no evidence/insufficient data:
- Physical function Eg. energy, vitality
- Cognitive function
- Mood/quality of life
What is the main cause of erectile dysfunction in older men?
Atherogenesis
What is the drug Sildenafil used for?
‘Viagra’ is used to treat erectile dysfunction
What are some risks of using testosterone as treatment in older men?
- Benign prostatic hypertrophy/ cancer
- Erythropoiesis
- Cardiovascular risk
What are the drugs Bisphosphonates used to treat?
Osteoporosis
What are risks of growth hormone treatment?
- Risk of cancer Eg. prostate, colon, breast
- Increased risk of T2 diabetes mellitus
Side effects: Soft tissue oedema, arthralgias, carpal tunnel syndrome
What is arthralgias?
Joint stiffness
What are the benefits of growth hormone treatment?
- Increased lean body mass
- Decreased fat mass
No convincing functional benefits demonstrated
How do cortisol levels change within the body as we age?
The trough increases
Time at trough and peak are both earlier
How does thyroid function change with age?
Slight increase in TSH with age
T4 stay the same
Decrease in T3 because there is less peripheral T4
What happens to insulin, glucose, and insulin sensitivity when the body is in starvation?
Decreased insulin
Decreased Glucose
Increased insulin sensitivity
(The opposite of obesity)
Where is leptin produced?
White adipose tissue
What is the function of Leptin within the body?
It reports nutritional information to the hypothalamus
Eg. Low leptin = increased food intake and decreased expenditure
Leptin concentrations correlate with BMI and body fat. Its also a permissive factor for initiation of puberty
What effect does starvation have on testosterone and oestrogen levels?
Decreased LH and FSH
Decreased oestrogen and testosterone
Decreased fertility (amenorrhoea)
