Mechanisms of Hypothalamic-Pituitary-Thyroid Axis Aging

下丘脑-垂体-甲状腺轴衰老的机制

• 批准号: 9973551
• 负责人: Jennifer Sophie Mammen
• 金额: $ 34.61万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973551
• 关键词: Adult; Affect; Age; Aging; Algorithms; Antibodies; Atrial Fibrillation; Autoantibodies; Autoimmunity; Baltimore; Biological Markers; Blood; Blood Tests; Chronic; Circadian Rhythms; Clinical; Diagnosis; Diagnostic; Diagnostic Specificity; Diagnostic tests; Disease; Early Diagnosis; Elderly; Etiology; Failure; Feedback; Functional disorder; Gold; Hip Fractures; Homeostasis; Hormone Responsive; Hormone use; Hormones; Hyperthyroidism; Hypothalamic structure; Hypothyroidism; Individual; Inflammation; Longitudinal Studies; Measures; Medical; Morbidity - disease rate; National Health and Nutrition Examination Survey; Organ; Outcome; Participant; Pattern; Phenotype; Pituitary Gland; Population; Predictive Value; Process; Production; Recording of previous events; Reference Values; Research; Research Design; Risk; Signal Transduction; Subgroup; Testing; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Time; Tissues; Treatment Cost; Work; accurate diagnosis; age related; autoimmune thyroid disease; base; bone loss; clinical practice; experimental study; follow-up; functional status; heart rhythm; hormone therapy; human old age (65+); hypothalamic-pituitary-thyroid axis; improved; in vitro Assay; metabolomics; novel; nutrition; overtreatment; personalized diagnostics; preservation; response; tool; treatment planning; treatment risk; trend

Abstract: Increases in the blood levels of the hormone thyrotropin (TSH), which regulates thyroid function, can signal thyroid disease in older adults; but changes may also represent adaptations to aging or changes in pituitary function. It is important for medical practice to know the difference in order to use hormone therapy in those who need it while avoiding harm from over-treatment in those who don’t. The two groups look the same when TSH is measured, but we know that there are underlying processes that are very different. By analyzing simultaneous trends in multiple hormones (TSH and thyroid hormones) for 640 participants in the Baltimore Longitudinal Study of Aging with between 3-12 years of follow up, we have demonstrated that both age related changes and thyroid disease occur in people with similar TSH levels. Therefore, a single TSH level, the current means of diagnosing early thyroid failure, is not enough to plan treatment in older adults. We are looking for other tests that could be done to tell the difference between adaptation and disease. We will compare the activity of the TSH hormone, the ability of the pituitary to respond to stimulation, the presence of antibodies, and other blood tests that may serve as markers between these different groups of people. This work is important because when older adults are treated with thyroid hormone un-necessarily, it can do more harm than good by increasing the risk of irregular heart rhythms or bone loss. We know that doctors in the US and the UK have become more aggressive in prescribing thyroid hormone over the past decade, and the number of older adults is growing rapidly, lending increased urgency to this research.

抽象的： 马酮甲状腺激素（TSH）的血液水平增加 甲状腺功能，可以在老年人中向甲状腺疾病发出信号。但是变化也可能 表示对衰老或居民功能变化的改编。这对 医学实践知道差异，以便在那些人中使用马内治疗 谁需要它，同时避免对那些不进行过度治疗的伤害。两个 测量TSH时，组看起来相同，但我们知道 截然不同的基础过程。通过分析同时的趋势 640名参与者的多种激素（TSH和甲状腺激素） 巴尔的摩对衰老的纵向研究，随访了3 - 2年，我们 已经证明，与年龄相关的变化和甲状腺疾病都发生在 TSH水平相似的人。因此，单个TSH级别，当前的含义 诊断早期甲状腺衰竭的诊断不足以计划老年人的治疗。 我们正在寻找其他可以进行的测试来判断 适应和疾病。我们将比较TSH Hornone的活动， 垂体对刺激的反应，抗体的存在和 其他可能用作这些不同组之间标记的血液检查 人们。这项工作很重要，因为当老年人接受甲状腺治疗时 不必要的马酮，它会增加弊大于利的弊大于利 不规则的心律或骨质流失。我们知道美国和英国的医生 过去在开处方甲状腺激素方面变得更具侵略性 十年，老年人的数量正在迅速增长，贷款增加 这项研究的紧迫性。