Mechanisms of Hypothalamic-Pituitary-Thyroid Axis Aging

下丘脑-垂体-甲状腺轴衰老的机制

• 批准号: 10261434
• 负责人: Jennifer Sophie Mammen
• 金额: $ 33.8万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10261434
• 关键词: Adult; Affect; Age; Aging; Algorithms; Antibodies; Atrial Fibrillation; Autoantibodies; Autoimmunity; Baltimore; Biological Markers; Blood; Blood Tests; Chronic; Circadian Rhythms; Clinical; Diagnosis; Diagnostic; Diagnostic Specificity; Diagnostic tests; Disease; Early Diagnosis; Elderly; Etiology; Failure; Feedback; Functional disorder; Gold; Hip Fractures; Homeostasis; Hormone Responsive; Hormone use; Hormones; Hyperthyroidism; Hypothalamic structure; Hypothyroidism; Individual; Inflammation; Longitudinal Studies; Measures; Medical; Morbidity - disease rate; National Health and Nutrition Examination Survey; Organ; Outcome; Participant; Pattern; Phenotype; Pituitary Gland; Population; Predictive Value; Process; Production; Recording of previous events; Reference Values; Research; Research Design; Risk; Signal Transduction; Subgroup; Testing; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Time; Tissues; Treatment Cost; Work; accurate diagnosis; age related; autoimmune thyroid disease; base; bone loss; clinical practice; experimental study; follow-up; functional status; heart rhythm; hormone therapy; human old age (65+); hypothalamic-pituitary-thyroid axis; improved; in vitro Assay; metabolomics; novel; nutrition; overtreatment; personalized diagnostics; preservation; response; tool; treatment planning; treatment risk; trend

Abstract: Increases in the blood levels of the hormone thyrotropin (TSH), which regulates thyroid function, can signal thyroid disease in older adults; but changes may also represent adaptations to aging or changes in pituitary function. It is important for medical practice to know the difference in order to use hormone therapy in those who need it while avoiding harm from over-treatment in those who don’t. The two groups look the same when TSH is measured, but we know that there are underlying processes that are very different. By analyzing simultaneous trends in multiple hormones (TSH and thyroid hormones) for 640 participants in the Baltimore Longitudinal Study of Aging with between 3-12 years of follow up, we have demonstrated that both age related changes and thyroid disease occur in people with similar TSH levels. Therefore, a single TSH level, the current means of diagnosing early thyroid failure, is not enough to plan treatment in older adults. We are looking for other tests that could be done to tell the difference between adaptation and disease. We will compare the activity of the TSH hormone, the ability of the pituitary to respond to stimulation, the presence of antibodies, and other blood tests that may serve as markers between these different groups of people. This work is important because when older adults are treated with thyroid hormone un-necessarily, it can do more harm than good by increasing the risk of irregular heart rhythms or bone loss. We know that doctors in the US and the UK have become more aggressive in prescribing thyroid hormone over the past decade, and the number of older adults is growing rapidly, lending increased urgency to this research.

摘要： 血液中促甲状腺激素(TSH)水平的增加，它调节 甲状腺功能，可以作为老年人患甲状腺疾病的信号；但变化也可能 代表对衰老或脑下垂体功能变化的适应。这一点对 医疗实践，以了解其中的区别，以便使用激素治疗 他们需要它，同时避免过度治疗对那些不需要的人造成的伤害。 当TSH被测量时，组看起来是一样的，但我们知道有 非常不同的潜在过程。通过分析以下方面的同步趋势 640名受试者的多种激素(促甲状腺激素和甲状腺激素) 巴尔的摩老龄化的纵向研究与3-12年的随访，我们 已经证明与年龄相关的变化和甲状腺疾病都发生在 促甲状腺激素水平相近的人。因此，单一的TSH水平，目前意味着 早期甲状腺功能衰竭的诊断，不足以计划老年人的治疗。 我们正在寻找其他可以做的测试来区分 适应和疾病。我们将比较促甲状腺激素激素的活性， 脑下垂体对刺激的反应能力，抗体的存在，以及 其他血液测试可以作为这些不同组之间的标志 人民。这项工作很重要，因为当老年人接受甲状腺治疗时 荷尔蒙不一定，它可能弊大于利，因为它增加了 心律不齐或骨质流失。我们知道美国和英国的医生 在过去，他们在开甲状腺激素的处方上变得更加积极 十年来，老年人的数量迅速增长，贷款增加 这项研究的紧迫性。

项目成果

Levothyroxine Dosing in Older Adults: Recommendations Derived From The Baltimore Longitudinal Study of Aging.

老年人左旋甲状腺素剂量：来自巴尔的摩老龄化纵向研究的建议。

• DOI: 10.1016/j.eprac.2023.05.002
• 发表时间: 2023
• 期刊: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
• 作者: Gavigan,Colleen;Abbey,EnochJ;McGready,John;Simonsick,EleanorM;Mammen,JenniferS
• 通讯作者: Mammen,JenniferS