Ferrari M, Mantero F
O.U. of Endocrinology, University of Padua, 35128 Padua, Italy.
J Endocrinol Invest. 2005;28(11 Suppl Proceedings):92-5.
The hypothalamic-pituitary-adrenal (HPA) axis in the aging male (adrenopause) is characterized by an unexplained reduction of DHEA secretion while ACTH and cortisol show no major changes, except for a lower amplitude of 24-h fluctuations and a tendency to higher cortisol values in the evening and night (especially in dementia). As a consequence, the cortisol/DHEAS ratio tends to be higher. Adrenocortical morphology reveals an age-related reduction in the thickness of the zona reticularis, and an increase of microhemorrhagic events. This may be one of the underlying causes of the age-dependent high frequency of adrenal nodules incidentally found in the elderly, which may seldom be hormonally active.
衰老男性的下丘脑-垂体-肾上腺（HPA）轴（肾上腺功能减退）的特征是脱氢表雄酮（DHEA）分泌出现不明原因的减少，而促肾上腺皮质激素（ACTH）和皮质醇没有重大变化，只是24小时波动幅度较小，且傍晚和夜间皮质醇值有升高趋势（尤其是在痴呆患者中）。因此，皮质醇/脱氢表雄酮硫酸酯（DHEAS）比值往往更高。肾上腺皮质形态显示，网状带厚度随年龄增长而变薄，微出血事件增多。这可能是老年人肾上腺结节高发的潜在原因之一，而这些结节很少具有激素活性。
