Ferrari E, Casarotti D, Muzzoni B, Albertelli N, Cravello L, Fioravanti M, Solerte S B, Magri F
Department of Internal Medicine and Medical Therapy, Chair of Geriatrics, University of Pavia, Piazza Borromeo 2, 27100, Pavia, Italy.
Brain Res Brain Res Rev. 2001 Nov;37(1-3):294-300. doi: 10.1016/s0165-0173(01)00133-3.
The biosynthetic dissociation of the adrenocortical secretion occurring with age may have a pathogenetic role in the pathophysiology of brain aging. We studied cortisol and DHEAS secretion in healthy old and young subjects, in senile dementia, in major depression of elderly subjects and in healthy centenarians. A clear age-related decline of DHEAS secretion was well evident in healthy centenarians, and a further decrease in DHEAS concentration was found in old depressed patients and moreover in the demented ones, by comparison with age-matched controls. The circadian profile of serum cortisol was clearly flattened in old subjects, due to the selective increase in the cortisol nocturnal levels, particularly evident in demented subjects; on the other hand, the morning serum cortisol levels were not significantly different among centenarians, young and old controls. The molar ratio between cortisol and DHEAS showed a significant age-related increase; the occurrence of senile dementia and of major depression played an additive role, by comparison to physiological aging. The qualitative and quantitative modifications of the adrenocortical secretion occurring with aging seem mainly dependent on age itself, but the occurrence of pathological conditions may amplify these changes. Since cortisol and DHEAS play opposite effects on the central nervous system, the evaluation of the ratio between cortisol and DHEAS seems to be a good marker of the neuroendocrine features in old subjects.
随着年龄增长而发生的肾上腺皮质分泌的生物合成解离可能在脑老化的病理生理学中具有致病作用。我们研究了健康的老年人和年轻人、老年痴呆症患者、老年重度抑郁症患者以及健康的百岁老人的皮质醇和脱氢表雄酮（DHEAS）分泌情况。在健康的百岁老人中，DHEAS分泌明显呈现与年龄相关的下降，与年龄匹配的对照组相比，老年抑郁症患者以及痴呆症患者的DHEAS浓度进一步降低。老年受试者血清皮质醇的昼夜节律明显变平，这是由于皮质醇夜间水平选择性升高所致，在痴呆症患者中尤为明显；另一方面，百岁老人、年轻和老年对照组的早晨血清皮质醇水平无显著差异。皮质醇与DHEAS的摩尔比显示出与年龄相关的显著增加；与生理性衰老相比，老年痴呆症和重度抑郁症的发生起到了累加作用。随着年龄增长而发生的肾上腺皮质分泌的定性和定量改变似乎主要取决于年龄本身，但病理状况的出现可能会放大这些变化。由于皮质醇和DHEAS对中枢神经系统具有相反的作用，因此评估皮质醇与DHEAS的比值似乎是老年受试者神经内分泌特征的一个良好指标。
