1. Ageing and Endocrine System
11NOV2008 Staff Lecture
Ageing and Endocrine System
Jeong-taek Woo
Department of Endocrinology and Metabolism
Kyung Hee University School of Medicine

3. Aging
A continuous, universal, progressive, intensive, deleterious, but democratic phenomenon
Secondary aging, pathologic aging

4. Theories of ageing Genetic Oxidative stress Mitochondrial dysfunction
Hormonal change
Telomere shortening
Defective host defenses
Accumulation of senescent cells

5. Antiaging theory in the late 1800s
Cellular theory
Elie Metchnikoff
Charles A. Stephens
Nutrition and hygiene
Arnold Berthold ( )
atrophy of the comb in castrated roosters
reversed by returning the testes of the castrated rooster to the abdomen

6. Birth of Endocrinology and Elixir of life (in June 1889 at the Societe de Biologie in Paris) published in the July 20, 1889 issue of The Lancet
Charles Edouard Brown-Sequard ( )

7. Advertisement depicting Brown-Sequard type elixir of life called Sequarine. Originally published in Strand Magazine in 1912

8. Autoplastic rejuvenation
Eugen Steinach ( )

9. Sex gland transplantation
Serge Voronoff ( )

10. Monkey Gland Type: Cocktail Primary alcohol by volume: Gin Absinthe
Standard drinkware: Cocktail glass
Commonly used ingredients:
1 part gin
1 part orange juice
dash absinthe
dash grenadine
Preparation: Shake well over ice cubes in a shaker, strain into a chilled cocktail glass.

11. Human testis transplantation in United States
Victor D. lespinasse ( )
Frank Lydston ( )
Published in the Journal of the American Medical Association in 1916
Leo L. Stanley ( )
Published in the journal of Endocrinology in 1922.

12. John R Brinkley (1885-1942) Performed more than 16,000 transplants
Revoked his medical lincense
Originally printed in New York Evening Journal

13. Main neuroendocrinal changes in aging

14. Insulin resistance and carbohydrate metabolism – glucose intolerance and diabetes
Calcium and bone metabolism – osteoporosis
Hypothalamic-pituitary thyroid axis – thyroid dysfunction
Fat metabolism and body composition – fat accumulation
Pineal gland and body composition – insomnia and disordered circadian rhythms
Thymus and immunological sequelae – tendency to infections

15. Somatopause
Annals of Internal Medicine 2007, 146:

16. AL. Barkan, Nature Clinical Practice Endocrinology & Metabolism July 2007, 3: 509
Peris TT et al, Journal of American Medical Association 2005, 294:

19. Diagnosis of GHD in adulthood
Who to test
Those with signs and symptoms of hypothalamic pituitary disease (endocrine, structural, and/or genetic causes)
Those who have received cranial irradiation or tumor treatment
Those with traumatic brain injury (TBI) or subarachnoid hemorrage
Idiothathic isolated GHD occuring de novo in the adult is not a recognized entity
Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II:
A statement of the GH Research Society in association with the European Society for Pediatric
Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society,
And Endocrine Society of Austrailia. European Journal of Endocrinology (2007) 157,

20. Andropause

21. J Clin Endocrinol Metab 89:4789-4796, 2004

22. Menopause

23. Benefits and risks of postmenopausal hormone therapy (HT)
Definite benefits
Menopausal symptoms
Osteoporosis
Definite risks
Endometrial cancer
Venous thromboembolism
Breast cancer
Probable or uncertain risks or benefits
CVD
Primary prevention increase in risk
Secondary prevention early increase in risk
Gallbladder disease increase in risk
Colorectal cancer decrease in risk
Cognitive dysfunction decrease in risk

24. Flowchart for identifying appropriate candidates for postmenopausal hormone-replacement therapy (HRT)
N Eng J Med 345:34-40, 2001

25. DHEA, an prohormone of sex steroids
Journal of Endocrinology 2005, 187:

26. Adrenopause
Horm Res 2004;62(suppl 3);

27. Mechanism of decreased production of DHEA-S and dissociation of cortisol and DHEA-S synthesis with aging
Horm Res 2004;62(suppl 3);

28. Dehydroepiandrosterone in adrenal insufficiency and ageing
Dehydroepiandrosterone in adrenal insufficiency and ageing. Bhagra S, et al Curr Opin Endocrinol Diabetes Obes Jun;15(3):239-43
Dehydroepiandrosterone replacement increases bone mineral
density in elderly subjects; however, the effect is relatively small
compared with established therapies for osteoporosis.
No additional benefits have been identified for long-term
dehydroepiandrosterone replacement, when used in the elderly to
prevent or delay ageing. Dehydroepiandrosterone replacement may
improve some metabolic variables and measures of psychological
well-being in adrenal deficiency, but these benefits are not
consistently sustained in long-term therapy. Long-term studies are
needed to confirm sustained benefits in adrenal deficiency and
establish long-term safety.

29. Summary of the significant age-related changes that have been measured in the CNS
Endocrine Review April 2005, 26(2):

30. Systems approach vs Reductionist methods Lifestyle modication