Pratt J H, Hawthorne J J, Debono D J
Department of Medicine, Indiana University School of Medicine, Indianapolis 46223.
Steroids. 1988 Jan-Feb;51(1-2):163-71. doi: 10.1016/0039-128x(88)90191-2.
Although aldosterone production declines with age, so does the aldosterone metabolic clearance rate (MCR), and the net effect of age on the circulating level of aldosterone may be less than can be predicted from production rates alone. The effect of age on aldosterone production and plasma levels was studied in a group of elderly individuals at a very advanced age when susceptibility to the impacts of age might be particularly pronounced. Seventeen nursing home patients, ages 75-99 (mean age 86 years), had aldosterone production assessed from the urinary excretion rate of the acid hydrolyzable 18-glucuronide conjugate of aldosterone. Aldosterone excretion was low in the elderly when compared to a group of healthy, young to middle-aged subjects: 123 +/- 19 (SEM) vs. 234 +/- 18 ng/h (P less than 0.001). However, plasma aldosterone concentrations in the elderly were well within a range observed in much younger and fully ambulatory subjects: 14.1 +/- 1.3 in the elderly vs. 15.9 +/- 1.8 ng/dL in the young. The plasma aldosterone concentration was apparently maintained at a normal level by a coincident decrease in both the metabolic clearance rate and the aldosterone production rate. In conclusion, an aldosterone deficiency state resulting from an age-correlated reduction in aldosterone production is probably uncommon in the elderly.
尽管醛固酮的分泌量会随着年龄增长而下降，但醛固酮的代谢清除率（MCR）也会下降，年龄对醛固酮循环水平的净效应可能小于仅根据分泌率所预测的结果。在一组高龄老年人中研究了年龄对醛固酮分泌和血浆水平的影响，因为在这个年龄段，年龄影响可能会特别显著。17名养老院患者，年龄在75 - 99岁（平均年龄86岁），通过测定醛固酮酸水解18 - 葡萄糖醛酸结合物的尿排泄率来评估醛固酮分泌情况。与一组健康的年轻至中年受试者相比，老年人的醛固酮排泄量较低：分别为123±19（SEM）与234±18 ng/h（P<0.001）。然而，老年人的血浆醛固酮浓度完全处于年轻得多且活动自如的受试者所观察到的范围内：老年人为14.1±1.3，年轻人为15.9±1.8 ng/dL。血浆醛固酮浓度显然是通过代谢清除率和醛固酮分泌率同时下降而维持在正常水平的。总之，因与年龄相关的醛固酮分泌减少导致的醛固酮缺乏状态在老年人中可能并不常见。
