Adrenal Androgens and Aging
- PMID: 25905237
- Bookshelf ID: NBK279006
Adrenal Androgens and Aging
Excerpt
Dehydroepiandrosterone (DHEA) and its metabolite DHEA sulfate (DHEAS), are steroid pre-hormones synthesized and secreted primarily by the zona reticularis of the adrenal cortex in response to adrenocorticotropic hormone (ACTH). They are both precursor hormones that may be transformed into weak androgens or estrogens. During the last decades, several epidemiologic and cohort studies have shown the age-related circulating levels of DHEA/DHEAS; these first increase in childhood, a process called “adrenarche”, peak in the 3rd decade of life, and progressively decrease in midlife, a phenomenon called “adrenopause”. Some authors have linked obesity in childhood with early adrenarche, i.e., increased circulating levels of adrenal androgens; others have associated low levels in late life with increased frailty and all-cause mortality. The potential clinical and therapeutic roles of DHEA/DHEAS have been studied extensively, but the data remain controversial and largely inconclusive. In this chapter, we provide an overview of the physiology and pathophysiology of adrenal androgen synthesis, secretion, and action and present current evidence regarding their efficacy in the management of adrenal insufficiency or aging-related disorders. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text,
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