Editorial: Thyroid Function and Aging: Do Serum 3,5,3′-Triiodothyronine and Thyroid-Stimulating Hormone Concentrations Give the Janus Response?

Mariotti, Stefano

doi:10.1210/jc.2005-2214

Cited by 32 publications

(31 citation statements)

References 22 publications

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“…Moreover, data from a large prospective cohort of community-dwelling older people (aged 70 -79 y at beginning), recently showed that sHT (serum TSH Ͼ 10 mIU/L) is associated with increased odds of prevalent, although not incident, metabolic syndrome (67). Nonetheless, a "physiological" age-dependent impairment of endothelial and cardiac function as well as lipid profile is well documented (60, 68 -70), and the effective burden of mild thyroid failure on the CV system of older people, mainly the oldest old, is still to be established and is widely debated (4,71).…”

Section: Sht and CV Disease Riskmentioning

confidence: 99%

Is Subclinical Hypothyroidism a Cardiovascular Risk Factor in the Elderly?

Pasqualetti

Tognini

Polini

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context:The negative impact of subclinical hypothyroidism (sHT) on cardiovascular risk, widely recognized in young adults (aged Ͻ55-60 y), is still debated in the elderly (Ͼ65 y), especially in the oldest olds (Ͼ80 y).Evidence Acquisition: We searched Medline for reports published with the following search terms: "hypothyroidism," "subclinical hypothyroidism," "ageing," "elderly," "L-thyroxin," "thyroid," "guidelines," "treatment," "quality of life," "cardiovascular risk," "heart failure," "coronary heart disease" (CHD), "atherosclerosis," and "endothelial dysfunction." We limited our search to reports in English published after 1980, although we incorporated some reports published before 1980. We supplemented the search with records from personal files, textbooks, and relevant articles. Analyzed parameters included the epidemiology of thyroid failure, the effect of thyroid hormone on the aging process, cardiovascular function, and CHD risk factors. We also included the potential benefits of L-T 4 therapy on the quality of life, cardiovascular events, and survival.Evidence Synthesis: TSH levels increase with age, even in older people without thyroid disease. Most longitudinal studies show an increased risk for CHD events and mortality in sHT participants. This increase is less evident in the elderly, mainly in cases of serum TSH values above 10 mIU/L. Lower mortality rate in a cohort of the oldest olds (Ͼ85 y) has been reported. Conclusions: sHT in older people should be not regarded as a unique condition, and moderately old patients (aged Ͻ70 -75 y) could be considered clinically similar to the adult population, albeit with a higher optimal TSH target value. Conversely, the oldest old subjects should be carefully followed with a wait-and-see strategy, generally avoiding hormonal treatment. The decision to treat elderly people is still an unresolved clinical challenge-first, due to a lack of appropriately powered randomized controlled trials of L-T 4 in sHT patients, examining cardiovascular hard endpoints in various classes of age; and second, because of the negative effects of possible overtreatment. (J Clin Endocrinol Metab 98: 2256 -2266, 2013) S ubclinical hypothyroidism (sHT), defined as serum TSH concentration above the upper limit of the reference range in the face of normal free T 4 (FT 4 ) and free T 3 (FT 3 ) levels, is common in the elderly (1-3). This biochemical condition encompasses several pathological entities, mainly represented by chronic autoimmune thyroiditis even if increasing TSH may represent a physiological aging process (4).Depending on the degree of TSH elevation, sHT has been related to hyperlipidemia, intermediary metabolism changes, arterial hypertension, reduced glomerular filtration rate, and neuropsychiatric alterations (5-11). The negative impact of sHT in terms of coronary heart disease (CHD) and global cardiovascular (CV) risk is mostly acknowledged in young adults, whereas it remains to be established in the elderly, especially in the oldest old (aged Ͼ 80 y) (4). Moreover, t...

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Section: Sht and CV Disease Riskmentioning

confidence: 99%

Is Subclinical Hypothyroidism a Cardiovascular Risk Factor in the Elderly?

Pasqualetti

Tognini

Polini

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Thyroid disorders in the elderly are not rare, but they frequently remain undiagnosed because their clinical symptoms are hardly noticeable and frequently changed or masked by concomitant illnesses and medications [23,25]. Acute diseases inhibit the peripheral conversion of T4 reducing the level of T3, at the same time increasing the concentration of the biologically inactive form of T3, so-called reverse triiodothyronine (rT3) [21,26,27,28,29]. Changes in the metabolism of thyroid hormones without diagnosable thyroid diseases are referred to as non-thyroidal illness syndrome (NTIS), euthyroid sick syndrome (ESS) or sick euthyroid syndrome (SES).…”

Section: Tarczycamentioning

confidence: 99%

“…Choroby o ciężkim przebiegu hamują konwersję obwodową T4, zmniejszając stężenie T3 i równocześnie podwyższając stężenie biologicznie nieaktywnej postaci T3, tzw. odwrotnej trijodotyroniny (rT3) [21,25,26,27,28,29]. Zmiany w metabolizmie hormonów tarczycy bez uchwytnych chorób tarczycy określa się mianem non-thyroidal illness syndrome (NTIS), euthyroid sick syndrome (ESS) lub sick euthyroid These syndromes occur in patients with myocardial infarction, sepsis, diabetic coma, following extensive thermal injuries, major surgical procedures and organ transplants.…”

Section: Tarczycaunclassified

The aging process and function of endocrine glands

Kazimierczak¹,

Nych²,

Marek³

et al. 2017

Ann. Acad. Med. Siles.

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Population aging is becoming the biggest medical challenge of the 21st century. The body of elderly people shows a decreased ability to adapt to changing environmental and intracorporeal conditions. Aging is a process that is complex and stretches over a considerable length of time. As we get older our bodies progressively change, including the endocrine system. The changes are not unidirectional and do not affect all the endocrine glands to the same degree. The secretion of some hormones becomes impaired, while the secretion of other ones increases. There are also some hormones whose secretion does not change. The frequent concomitance of chronic diseases and taking many medications makes it difficult to interpret the results of studies on changes in hormone secretion in elderly people. This paper focuses on aging-related changes in the secretion of growth hormone, thyroid hormones, parathyroid and adrenal hormones. K E Y W O R D Saging, somatopause, thyroid hormones, parathyroid glands hormones, adrenal gland hormones ST R ES ZCZ E N IEStarzenie społeczeństw staje się największym wyzwaniem medycznym XXI w. Organizm osób w podeszłym wieku wykazuje obniżoną umiejętność przystosowywania się do zmiennych warunków środowiska zewnętrznego i wewnętrznego. Starzenie to proces złożony i znacznie rozciągnięty w czasie. Wraz z wiekiem dochodzi do postępu-jących zmian w ustroju, w tym do zmian w układzie endokrynnym. Zmiany te nie są jednokierunkowe i nie dotyczą w równym stopniu wszystkich gruczołów dokrewnych. Wydzielanie części hormonów ulega upośledzeniu, innych

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“…Molte evidenze scientifiche documentano una tendenza alla riduzione della funzione tiroidea con l'avanzare dell'età sia in termini di produzione ormonale che di uptake dello iodio [4]. Dati più contrastanti sono invece quelli riguardanti i livelli circolanti di TSH in funzione dell'età [1,7]. Le prime esperienze cliniche pubblicate sui grandi anziani avevano documentato valori medi di TSH più bassi rispetto ai controlli giovani, associati a ridotti livelli circolanti di FT3.…”

Section: Funzione Tiroidea E Invecchiamentounclassified

Ipotiroidismo subclinico nel paziente anziano: sindrome clinica o condizione parafisiologica?

et al. 2015

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Un lieve deficit della funzione tiroidea o ipotiroidismo\ud subclinico (sHT), definito a livello biochimico\ud come una concentrazione di ormone stimolante la tiroide\ud (TSH) oltre il limite superiore del range di riferimento associato\ud a valori normali di T4 (FT4) e T3 (FT3) liberi,\ud è una condizione clinica frequente nella popolazione generale,\ud specie nelle donne, la cui prevalenza aumenta con\ud l’aumentare dell’età. Va comunque sottolineato come, con\ud l’invecchiamento, si assista a un progressivo aumento dei\ud valori medi di TSH che, secondo alcuni autori, renderebbe\ud necessario definire range specifici di normalità. In generale,\ud l’attività tiroidea potrebbe avere un legame con l’invecchiamento\ud per l’intimo collegamento tra metabolismo basale\ud e i processi catabolici (accelerati nell’invecchiamento).\ud L’ipotiroidismo subclinico è stato associato a iperlipidemia,\ud alterazioni del metabolismo glucidico, ipertensione arteriosa\ud sistemica e malattia cardiovascolare, così come ad alcune\ud condizioni neuro-psichiatriche, incluso il deterioramento\ud cognitivo. La correlazione tra eventi e/o mortalità cardiovascolare\ud e sHT non è ancora completamente chiarita e dati\ud apparentemente conflittuali sono stati riportati in letteratura,\ud soprattutto per quanto riguarda i grandi anziani (>80 anni).\ud I pochi e contrastanti risultati della letteratura non consentono\ud di delineare un chiaro ruolo dell’sHT nel processo di deterioramento delle funzioni cognitive. Di conseguenza, il\ud quesito clinico fondamentale nei pazienti con sHT è quello\ud di stabilire quando e se intraprendere la terapia ormonale\ud sostitutiva, anche in relazione al rischio potenziale di effetti\ud collaterali, particolarmente nei grandi anziani

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Editorial: Thyroid Function and Aging: Do Serum 3,5,3′-Triiodothyronine and Thyroid-Stimulating Hormone Concentrations Give the Janus Response?

Cited by 32 publications

References 22 publications

Is Subclinical Hypothyroidism a Cardiovascular Risk Factor in the Elderly?

Is Subclinical Hypothyroidism a Cardiovascular Risk Factor in the Elderly?

The aging process and function of endocrine glands

Ipotiroidismo subclinico nel paziente anziano: sindrome clinica o condizione parafisiologica?

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