Table Of ContentEndocrine Function and Aging
H.J. Armbrecht R.M. Coe
N. Wongsurawat
Editors
Endocrine Function
and Aging
With an Introduction by T.F. Williams
With 48 Figures
Springer Science+ Business Media, LLC
H. JAMES ARMBRECHT, PH.D.
Geriatrie Research, Education, and Clinica! Center, Veterans Administration Medical
Center, St. Louis, Missouri 63125; Departments oflnternal Medicine and Biochemistry,
St. Louis University School ofMedicine, St. Louis, Missouri 63104, U.S.A.
RooNEY M. CoE, PH.D.
Departments ofCommunity Medicine and Internat Medicine, St. Louis University School
of Medicine, St. Louis, Missouri 63104; Geriatrie Research, Education, and Clinica!
Center, Veterans Administration Medical Center, St. Louis, Missouri 63125, U.S.A.
NIRANDON WONGSURAWAT, M.D., F.A.C.P.
Geriatrie Research, Education, and Clinica! Center, Veterans Administration Medical
Center, St. Louis, Missouri 63125; Department oflnternal Medicine, St. Louis University
School of Medicine, St. Louis, Missouri 63104, U.S.A.
Library of Congress Cataloging-in-Pub1ication Data
Endocrine function and aging 1 H. James Armbrecht, Rodney M. Coe,
Nirandon Wongsurawat, editors.
p. cm.
Derived from a conference he1d Sept. 14-15, 1988 in St. Louis, Mo.
Includes bib1iographical references.
ISBN 978-1-4612-7930-3 ISBN 978-1-4612-3240-7 (eBook)
DOI 10.1007/978-1-4612-3240-7
1. Endocrine g1ands-Diseases-Age factors-Congresses.
2. Endocrine g1ands-Aging-Congresses. 3. Aged-Diseases
Congresses. 1. Armbrecht, H. James. II. Coe, Rodney M.
III. Wongsurawat, Nirandon.
[DNLM: 1. Aging-congresses. 2. Neurosecretion-in o1d age
congresses. 3. Neurosecretory Systems-physio1ogy-congresses.
WL 102 E553 1988]
RC649.E515 1989
618.97'64-dc20
DNLM/DLC
for Library of Congress 89-21896
Printed on acid-free paper
© 1990 Springer Science+Business Media New York
Originally published by Springer-Ver1ag New York !ne. in 1990
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Typeset by Publishers Service, Bozeman, Montana.
9 8 7 6 5 4 3 2 1
This book is dedicated to our wives
Linda, Elaine, and Vanee
for their support and encouragement
during its preparation.
Preface
One of the hallmarks of aging is the decreased capacity to adapt to changes in the
environment. In a constant, controlled environment, it is often difficult to distin
guish the functioning of the young organism from that of the old. However, when
stresses are applied-temperature stresses, dietary stresses, infection, emotional
stresses-the differences are more apparent. Frequently, the response ofthe old
is delayed and may never reach the same mag'nitude as the young. These
responses, in most cases, are mediated by the neuroendocrine system, which
communicates via hormones, neurotransmitters, and related substances. Thus, it
is important to understand the age-related changes that take place in the secretion
and act ion of these substances and how these changes relate to the well-being of
the whole organism. Indeed, the "neuroendocrine theory of aging" proposes that
almost all of the characteristics of aging can be accounted for by dysfunction of
the neuroendocrine system.
A book on endocrine function and aging is particularly relevant at this time.
With the advent of the techniques of molecular biology, there has bee~ an explo
sion of knowledge concerning hormone secretion and action. Hormones, pro
hormones, hormone receptors, and "second messenger" mediators rapidly are
being cloned and sequenced. Such knowledge gives us important insights into the
molecular workings of these substances as well as into the genetic hasis of endo
crine dysfunction. These new tools are now being applied to the problem of age
related changes in endocrine function. Examples in this book include the study
ofthe renal adenylate cyclase system by Liang and colleagues (Chapter 8) and the
study ofthe tyrosine hydroxylase enzyme by Strong and colleagues (Chapter 17).
This volume has been organized around the role of the endocrine system in
maintaining homeostasis in the face of environmental stresses. For example, the
endocrine system regulates carbohydrate metabolism (Section Il), maintains
bone structure (Section III) and reproductive function (Section IV), and regu
lates blood pressure (Section V). Age-related changes in endocrine function lead
to associated disease states such as diabetes, osteoporosis, impotence, and hyper
tension. In this book, we have not sought to make a sharp distinction between the
characteristics of aging per se and age-associated diseases. As Dr. Roth states in
Chapter 3, we will •: .. discuss changes in hormone action which occur as a func
tion of aging, whether they are secondary to age-related disease or not. Since
vm Preface
such alterations result in profound homeostatic imbalance and severely decrease
the probability of survival, they would appear tobe worthy of attention regardless
of immediate cause."
In each section, there is first a ciini cal perspective on the symptoms and treat
ment of endocrine dysfunction in the elderly. One or more chapters presenting
recent research advances in the field then follow. We hope that this format will
acquaint clinicians with the latest research findings and will familiarize basic
researchers with the clinical problems in the field.
The first section of this volume is a broad overview of age-related changes in
hormone secretion and action. An overview of the hypothalamic and pituitary
hormones is provided in the first and second chapters, respectively, and the evi
dence for altered calcium mobilization in a wide variety of tissues is summarized
in the third. The second section, carbohydrate metabolism and diabetes, begins
with a clinical presentation and is followed by a summary of current research
findings in humans. The section on bone structure consists of a chapter on the
diagnosis and treatment of osteoporosis and two chapters describing recent
studies of age-recent changes in hormone action in rats. The next section on
reproductive function consists of two chapters covering physiological changes in
the male and the female, respectively, and one chapter regarding psychological
aspects of sexual changes with aging. The section on blood pressure contains
chapters on the treatment of hypertension in the elderly and a summary of recent
laboratory studies on the effect of diet on hypertension. The last section, adapta
tion to stress, begins with chapters on the endocrine basis of the stress response
and the treatment of stress in the elderly. This section concludes with chapters
summarizing current research regarding the synthesis of glucocorticoids and
catecholamines, two important classes of stress-related hormones.
We wish to express our appreciation for the financial and administrative sup
port for the conference that led to this publication. Support was provided to the
St. Louis Veterans Administration Geriatrie Research, Education, and Clinica!
Center (GRECC) by a continuing education grant from the Veterans Administra
tion Office of Academic Affairs through the Office of Geriatrics and Extended
Care, and also by the Veterans Administration South Central Regional Medical
Education Center. Administrative support was received from St. Louis College of
Pharmacy and St. Louis University School of Medicine.
We would like to thank Diana Coibion, Cheryl Mason, and Carolyn Leach of
the St. Louis GRECC for their administrative, technical, and moral support.
Finally, we would like to thank the individual contributors for their excellent con
ference presentations and chapter manuscripts, which form the basis of this
volume.
H.J. ARMBRECHT
R.M. CoE
N. WONGSURAWAT
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
lntroduction: Endocrinology in Aging-A Perspective. . . . . . . . . . . . . . . . xvii
T.F. WILLIAMS
Section 1: Age-Related Changes in Hormone Secretion aud Action
1. Alterations in Hypothalamic-Pituitary Function with Age ........ .
JOSEPH MEITES
2. Alterations in Hormone Syntheses and Secretion with Age . . . . . . . . 13
F.J. MANGIACAPRA ANO JAMES R. FLORINI
3. Changes in Hormone Action with Age: Altered Calcium
Mobilization and/or Responsiveness Impairs Signal
Transduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
GEORGE S. ROTH
Section II: Regulation of Carbohydrate Metabolism (Diabetes)
4. Pathogenesis and Management of Non-lnsulin-Dependent
Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
WILLIAM C. DUCKWORTH
5. Glucose Tolerance, Insulin Sensitivity, and Age . . . . . . . . . . . . . . . . . 48
DARIUSH ELAHI, BARBARA CLARK, ANO REUBIN ANORES
x Contents
Section III: Maintenance of Bone Structure (Osteoporosis)
6. Diagnosis and Treatment of Osteoporosis 67
WILLIAM A. PECK
7. Changes in the Production and Action of 1,25-Dihydroxy-
vitamin D and Parathyroid Hormone with Age . . . . . . . . . . . . . . . . . . 79
H. lAMES ARMBRECHT AND NIRANDON WoNGSURAWAT
8. Effect of Age on PTH-Stimulated Sodium Calcium Exchange
Activity: Alteration at Cellular and Molecular Levels . . . . . . . . . . . . 88
C.T. LIANG, H. HANAI, L. CHENG, J. BARNES, AND B. SACKTOR
Section IV: Maintenance of Reproductive Function (Impotence)
9. Testicular Function in the Aging Male . . . . . . . . . . . . . . . . . . . . . . . . . 99
JouN E. MoRLEY AND FRAN E. KAISER
10. Management of Female Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
RONALD C. STRICKLER
11. Psychological Aspects of Sexual Dysfunction in the Elderly . . . . . . . . 136
MARK L. ELLIOTT
Section V: Regulation of Blood Pressure (Hypertension)
12. Treatment of Hypertension in the Elderly 147
MICHAEL L. TuCK
13. :Macronutrients in the Diet: A Possible Association with
Age-Related Hypertension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
HARRY G. PREUSS, MOHMED ZEIN, JORGE L. AREAS,
AND GAo CuuN YuN
Section VI: Adaptation to Stress
14. Stress, Hypothalamic-Pituitary-Adrenal Function, and Aging:
Focus on Corticotropin-Releasing Factor . . . . . . . . . . . . . . . . . . . . . . . 175
J.C. PRYOR AND C.B. NEMEROFF
15. Treating Stress Response in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . 186
MARGIE K. EDEL
Contents xi
16. Cholesterol and Age-Related Changes in Adrenal
Steroidogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
SALMAN AzHAR, PHILIP Y. PoPPLEWELL, AND EvE REAVEN
17. Age-Related Changes in Adrenal Catecholamine Content
and Tyrosine Hydroxylase Gene Expres sion: Effects of Dietary
Restriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
R. STRONG, M.A. MoaRE, C. HALE, W.J. BuRKE,
H.J. ARMBRECHT, AND A. RICHARDSON
Index....................................................... 229
