Aging and age-related diseases represent hot topics of current research. Progressive damage in morphology and function of cells and tissue characterizes the normal process of aging, that is influenced by both genetic and environmental factors. The ability of each individual to adapt to these stressors defines the type of aging and the onset of age-related diseases (i.e. metabolic syndrome, inflammatory disorders, cancer and neurodegenerative diseases). The endocrine system plays a critical role in this process, because of its complex relationships with brain, immune system, and skeletal muscle; thus, alterations in hormonal networks occur during aging to maintain homeostasis, with consequent under- or overactivity of specific hypothalamic-pituitary-peripheral hormone axes. On the other hand, the increase in life expectancy has led to increasing incidence of age-related diseases, including endocrine disorders, which may prompt assessment of endocrine function in aging individuals. In this context, there is growing awareness that natural changes of endocrine physiology and physiopathology occurring with increasing age may necessitate age-driven diagnostic cut-offs requiring validation in the elderly. This review aims to analyse the available literature on the hormone response to the most important dynamic tests currently used in the clinical practice for the screening of anterior pituitary-related diseases, to underline pitfalls in interpretation during aging.


中文翻译：

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垂体内分泌学的动态测试：衰老过程中的解释陷阱

衰老和与年龄相关的疾病是当前研究的热门话题。细胞和组织的形态和功能的进行性损伤是正常衰老过程的特征，受遗传和环境因素的影响。每个人适应这些压力源的能力决定了衰老的类型和与年龄相关的疾病（即代谢综合征、炎症性疾病、癌症和神经退行性疾病）的发病。内分泌系统在这个过程中起着至关重要的作用，因为它与大脑、免疫系统和骨骼肌有着复杂的关系；因此，在衰老过程中会发生激素网络的改变以维持体内平衡，从而导致特定的下丘脑-垂体-外周激素轴活动不足或过度活动。另一方面，预期寿命的增加导致与年龄有关的疾病的发病率增加，包括内分泌失调，这可能促使对老年人的内分泌功能进行评估。在这种情况下，人们越来越意识到随着年龄增长而发生的内分泌生理学和生理病理学的自然变化可能需要年龄驱动的诊断截止值，需要在老年人中进行验证。这篇综述旨在分析现有的关于激素对目前临床实践中用于筛查垂体前叶相关疾病的最重要动态测试的反应的文献，以强调衰老过程中的解释缺陷。人们越来越意识到，随着年龄的增长，内分泌生理学和病理生理学的自然变化可能需要年龄驱动的诊断截止值，需要在老年人中进行验证。这篇综述旨在分析现有的关于激素对目前临床实践中用于筛查垂体前叶相关疾病的最重要动态测试的反应的文献，以强调衰老过程中的解释缺陷。人们越来越意识到，随着年龄的增长，内分泌生理学和病理生理学的自然变化可能需要年龄驱动的诊断截止值，需要在老年人中进行验证。这篇综述旨在分析现有的关于激素对目前临床实践中用于筛查垂体前叶相关疾病的最重要动态测试的反应的文献，以强调衰老过程中的解释缺陷。