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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Complex changes occur within the endocrine system of ageing individuals. This article explores the changes that occur in the metabolism and production of various hormones and discusses the resulting clinical consequences. As individuals age there is a decline in the peripheral levels of oestrogen and testosterone, with an increase in luteinizing hormone, follicle-stimulating hormone and sex hormone-binding globulin. Additionally there is a decline in serum concentrations of growth hormone, insulin-like growth factor-I and dehydroepiandrosterone and its sulphate-bound form. Even though there are complex changes within the hypothalmo-pituitary-adrenal/thyroid axis, there is minimal change in adrenal and thyroid function with ageing. The clinical significance of these deficiencies with age are variable and include reduced protein synthesis, decrease in lean body mass and bone mass, increased fat mass, insulin resistance, higher cardiovascular disease risk, increase in vasomotor symptoms, fatigue, depression, anaemia, poor libido, erectile deficiency and a decline in immune function. For each endocrine system, studies have been carried out in an attempt to reverse the effects of ageing by altering the serum hormonal levels of older individuals. However, the real benefits of hormonal treatment in older individuals are still being evaluated.
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PMID:The endocrine system and ageing. 1720 Sep 39

We here report a 77-year-old Japanese male who suffered general fatigue with progressive thirst and polyuria. Central diabetes insipidus was diagnosed by depletion of vasopressin secretion in response to increases in serum osmolality. Secretory responses of anterior pituitary hormones including adrenocorticotropin, thyrotropin, gonadotropins and growth hormone were severely impaired. Diffuse swelling of the infundibulum as well as lack of T1-hyperintense signal in the posterior lobe was noted by pituitary magnetic resonance imaging. The presence of bilateral hilar lymphadenopathy and increased CD4/CD8 ratio in bronchoalveolar lavage fluid was diagnostic for lung sarcoidosis. Physiological doses of corticosteroid and thyroid hormone were administered in addition to desmopressin supplementation. Complete regression of the neurohypophysial swelling was notable two years after corticosteroid replacement. Diffuse damage of anterior pituitary combined with hypothalamic involvement leading to central diabetes insipidus is a rare manifestation in such elderly patients with neurosarcoidosis.
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PMID:An elderly patient with sarcoidosis manifesting panhypopituitarism with central diabetes insipidus. 1744 53

The adult growth hormone deficiency (GHD) syndrome is a well-defined clinical entity. Although the symptoms of GHD are not age specific, their relative importance differs depending on the patient's age, and the impact of GHD varies throughout adult life. Ceasing growth hormone (GH) therapy soon after final height in patients with severe GHD potentially limits somatic development by reducing accrual of bone and muscle mass. It is now recognized that the continuation of GH therapy in the transition years is required to achieve adult levels of somatic development. In middle age, the most worrying feature of GHD is the increase in cardiovascular risk, an important component of which is GHD-related dyslipidemia. One of the most profound effects of GH therapy in this age group is the durable reduction in cholesterol levels. Elderly GH-deficient patients experience the symptoms of GHD over and above the signs of normal aging. Perhaps most importantly, these patients have impaired quality of life, with fatigue as a major component. Evidence is growing for improved quality of life with GH therapy in the elderly. This review describes the diagnosis, symptoms and treatment of GHD specific to the different age groups.
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PMID:Growth hormone replacement throughout life: insights into age-related responses to treatment. 1756 Jan 53

We encountered a rare case of neurohypophyseal germinoma with a prominent granulomatous reaction, which invaded the right cavernous sinus. The neuroimaging and histopathology features in this case were unique, distinguishing it from other types of suprasellar lesions. A 13-year-old boy presented with loss of appetite and polyuria; both symptoms were present for 1 year, and headache, general fatigue and blurred vision present for the prior 2 months. On admission, neurological examination indicated bitemporal hemianopsia and optic atrophy. Endocrinological exam showed panhypopituitarism. Tumor markers such as alpha-fetoprotein, human growth hormone, carcinoembryonic antigen, and placental alkaline phosphatase were negative. Brain CT revealed a suprasellar tumor with calcification. MR T(1)-weighted and T(2)-weighted images showed the tumor to be isointense to normal brain parenchyma and to be enhanced densely. The tumor also involved the right cavernous sinus, so that a biopsy was performed by the transsphenoidal approach. On pathologic examination of the specimen, typical large tumor cells with lymphocytic cell infiltration and prominent granulomatous reaction were observed. Neurohypophyseal granulomatous germinoma was diagnosed. Radiotherapy was performed with a total dose of 51 Gy and the tumor shrank remarkably. The patient returned to school under hormone replacement therapy.
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PMID:Neurohypophyseal granulomatous germinoma invading the right cavernous sinus: case report and review of the literature. 1762 46

Carbohydrate ingestion after prolonged strenuous exercise enhances recovery, but protein might also be important. In a crossover with 2-wk washout, 10 cyclists completed 2.5 h of intervals followed by 4-h recovery feeding, provided 218 g protein, 435 g carbohydrate, and 79 g fat (protein enriched) or 34 g protein, 640 g carbohydrate, and 79 g fat (isocaloric control). The next morning, cyclists performed 10 maximal constant-work sprints on a Velotron cycle ergometer, each lasting approximately 2.5 min, at approximately 5-min intervals. Test validity was established and test reliability and the individual response to the protein-enriched condition estimated by 6 cyclists'repeating the intervals, recovery feeding, and performance test 2 wk later in the protein-enriched condition. During the 4-h recovery, the protein-enriched feeding had unclear effects on mean concentrations of plasma insulin, cortisol, and growth hormone, but testosterone was 25% higher (90% confidence limits, +/- 14%). Protein enrichment also reduced plasma creatine kinase by 33% (+/-38%) the next morning and reduced tiredness and leg-soreness sensations during the sprints, but effects on mean sprint power were unclear (-1.4%, +/-4.3%). The between-subjects trial-to-trial coefficient of variation in overall mean sprint power was 3.1% (+/-3.4%), whereas the variation in the protein-enriched condition was 5.9% (+/-6.9%), suggesting that individual responses to the protein-enriched treatment contributed to the unclear performance outcome. To conclude, protein-enriched recovery feeding had no clear effect on next-day performance.
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PMID:Effect of protein-rich feeding on recovery after intense exercise. 1815 59

The authors aimed to examine the acute hormonal and performance responses to resistance exercise with and without prior consumption of an amino acid/creatine/energy supplement. Eight men performed a resistance-exercise protocol at baseline (BL), 20 min after consuming a supplement (S) consisting of essential amino acids, creatine, taurine, caffeine, and glucuronolactone or a maltodextrin placebo (P). Venous blood samples were obtained before and immediately after (IP), 15 min (15P), and 30 min (30P) after each protocol. Area under the curve of resistance-exercise volume revealed that BL was significantly less than S (10%) and P (8.6%). For fatigue rate, only S (18.4% +/- 12.0%) was significantly lower than BL (32.9% +/- 8.4%). Total testosterone (TT) and growth hormone (GH) were significantly elevated at IP and 15P in all conditions. The GH response was significantly lower, however, in S and P than in BL. The TT and GH responses did not differ between S and P. These results indicated that a supplement consisting of amino acids, creatine, taurine, caffeine, and glucuronolactone can modestly improve high-intensity endurance; however, the anabolic-hormonal response was not augmented.
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PMID:Effects of an amino acid/creatine energy supplement on the acute hormonal response to resistance exercise. 1815 65

Combined inhibition of dopamine (DA)/norepinephrine (NE) reuptake improves exercise performance and increases core temperature in the heat. A recent study demonstrated that this effect may primarily be related to increased DA activity. NE reuptake inhibition (NERI), however, has received little attention in humans, certainly in the heat, where central fatigue appears to be a main factor influencing performance. Therefore the present study examines the effect of NERI (reboxetine) on exercise capacity, thermoregulation, and hormonal response in normal and high temperature. Nine healthy well-trained male cyclists participated in this study. Subjects ingested either placebo (Pla; 2 x 8 mg) or reboxetine (Rebox; 2 x 8 mg). Subjects exercised in temperate (18 degrees C) or warm (30 degrees C) conditions and cycled for 60 min at 55% W(max) immediately followed by a time trial (TT; Pla18/Rebox18; Pla30/Rebox30) to measure exercise performance. Acute NERI decreased power output and consequently exercise performance in temperate (P = 0.018) and warm (P = 0.007) conditions. Resting heart rate was significantly elevated by NERI (18 degrees C: P = 0.02; 30 degrees C: P = 0.018). In Rebox18, heart rate was significantly higher than in the Pla18, while in the heat no effect of the drug treatment was reported during exercise. In Rebox30, all hormone concentrations increased during exercise, except for growth hormone (GH), which was significantly lower during exercise. In Rebox18, prolactin (PRL) concentrations were significantly elevated; GH was significantly higher at rest, but significantly lower during exercise. In conclusion, manipulation of the NE system decreases performance and modifies hormone concentrations, thereby indicating a central NE effect of the drug. These findings confirm results from previous studies that predominantly increased DA activity is important in improving performance.
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PMID:Acute norepinephrine reuptake inhibition decreases performance in normal and high ambient temperature. 1849 77

The purpose of this review is to enlighten the mechanisms of skeletal muscle dysfunction in heart failure. The muscle hypothesis suggests that chronic heart failure (CHF) symptoms, dyspnoea and fatigue are due to skeletal muscle alterations. Hyperventilation due to altered ergoreflex seems to be the cause of shortness of breath. Qualitative and quantitative changes occurring in the skeletal muscle, such as muscle wastage and shift from slow to fast fibers type, are likely to be responsible for fatigue. Mechanisms leading to muscle wastage in chronic heart failure, include cytokine-triggered skeletal muscle apoptosis, but also ubiquitin/proteasome and non-ubiquitin-dependent pathways. The regulation of fibre type involves the growth hormone/insulin-like growth factor 1/calcineurin/ transcriptional coactivator PGC1 cascade. The imbalance between protein synthesis and degradation plays an important role. Protein degradation can occur through ubiquitin-dependent and non-ubiquit-independent pathways. Systems controlling ubiquitin/ proteasome activation have been described. These are triggered by tumour necrosis factor and growth hormone/ insulin-like growth factor 1. However, an important role is played by apoptosis. In humans, and experimental models of heart failure, programmed cell death has been found in skeletal muscle and interstitial cells. Apoptosis is triggered by tumour necrosis factor and in vitro experiments have shown that it can be induced by its second messenger sphingosine. Apoptosis correlates with the severity of the heart failure syndrome. It involves activation of caspases 3 and 9 and mitochondrial cytochrome c release. Sarcomeric protein oxidation and its consequent contractile impairment can form another cause of skeletal muscle dysfunction in CHF.
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PMID:Physiological basis for contractile dysfunction in heart failure. 1899 74

The objective of this study was to establish the effect of moderate intensity endurance training on muscle strength in relation to hormonal changes in the body. Fifteen young, healthy men took part in 5 week endurance training performed on a cycloergometer. Before and after training program, exercise testing sessions were performed involving all participants. Training program significantly increased V(O2 max) (P<0.05) and time to fatigue at 50% of maximal voluntary isometric contraction (TTF 50% MVC), P<0.03, but it did not affect maximal voluntary isometric contraction (MVC). This was accompanied by an increase (P<0.001) in total plasma testosterone (T) and free testosterone (fT) concentrations, whereas a decrease in sex hormone-binding globulin (SHBG) (P<0.02), growth hormone (P<0.05), free triiodothyronine (P<0.001) and free thyroxine (P<0.02) concentrations was observed. No changes were found in plasma cortisol (C) and insulin-like growth factor-I (IGF-I) concentrations. Additionally, MVC was positively correlated to T/C, fT/C and IGF-I/C ratios after the training, whereas time to fatigue at 50% of MVC was closely positively correlated to the SHBG concentration, both before and after endurance training. We have concluded that moderate intensity endurance training resulting in a significant increase in V(O2 max), did not affect the MVC, but it significantly increased time to fatigue at 50% of MVC. This index of local muscular endurance was greater in subjects with higher concentration of SHBG, both before and after the training.
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PMID:The effect of endurance training on muscle strength in young, healthy men in relation to hormonal status. 1925 59

In vitro isotonic and isometric mechanical properties of the sternohyoid (SH) muscle, an upper airway dilator muscle, were studied in rats with a growth hormone (GH)-secreting tumour (GH tumour group; n = 10). The effects of muscle fatigue were also studied. Stress and shortening were measured in muscles contracting from zero load up to isometric load under tetanic conditions. Isometric stress and maximum unloaded shortening velocity were determined and compared with values obtained from control rats (n = 10). Crossbridge kinetics and energetics and mechanical efficiency were calculated from Huxley's equations. Compared with controls, isometric stress, mechanical efficiency, crossbridge number and crossbridge single force were lower in the GH tumour group. The probability of crossbridge being in the power stroke configuration was lower in the GH tumour group than in controls. Muscle fatigue significantly impaired maximal muscle efficiency and crossbridge single force in the GH tumour group but not in controls. In conclusion, mechanical and energetic properties of the SH muscle and crossbridge properties were worse in the GH tumour group than in controls. This may partly account for impairment of the upper airway dilator muscle function and the increased occurrence of obstructive sleep apnoea in acromegaly.
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PMID:Growth hormone excess and sternohyoid muscle mechanics in rats. 1935 44


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