Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
Clin Interv Aging. 2023 Mar 21;18:423-439. doi: 10.2147/CIA.S370782. eCollection 2023.
The current increase of life expectancy is associated with the presence of endocrine diseases in the elderly. The management of hypopituitarism in this group of patients is a challenging task. A correct diagnosis, which represents an essential requisite for an appropriate medical treatment, can be difficult because of the physiological changes occurring in pituitary function with aging, which may lead to challenges in the interpretation of laboratory results. Furthermore, the treatment requires several careful considerations: the need to restore the hormonal physiology with replacement therapies must be balanced with the need to avoid the risks of the over-replacement, especially in the presence of concomitant cardiovascular and metabolic disease. Interactions with other drugs able to modify the absorption and/or the metabolism of hormonal replacement therapies should be considered, in particular for the treatment of hypoadrenalism and hypothyroidism. The most important challenges stem from the lack of specific studies focused on the management of hypopituitarism in older people.
目前预期寿命的延长与老年人内分泌疾病的存在有关。管理这组患者的垂体功能减退症是一项具有挑战性的任务。正确的诊断，这是适当治疗的必要条件，由于垂体功能随年龄增长而发生的生理变化，可能导致实验室结果的解释出现困难。此外，治疗需要仔细考虑几个方面：需要用替代疗法恢复激素生理学，必须与避免过度替代的风险相平衡，特别是在存在心血管和代谢疾病的情况下。应考虑与其他能够改变激素替代疗法吸收和/或代谢的药物相互作用，特别是治疗肾上腺功能减退和甲状腺功能减退症。最重要的挑战源于缺乏针对老年人垂体功能减退症管理的具体研究。
