The physiology of endocrine systems with ageing

van den Beld, Annewieke W; Kaufman, Jean-Marc; Zillikens, M Carola; Lamberts, Steven W J; Egan, Josephine M; van der Lely, Aart J

doi:10.1016/s2213-8587(18)30026-3

Cited by 349Hormonal and reproductive studiesGrowth Hormone and Insulin-like Growth FactorsMenopause: Health Impacts and Treatments

The physiology of endocrine systems with ageing

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van den Beld, Annewieke W, Kaufman, Jean-Marc, Zillikens, M Carola, Lamberts, Steven W J, Egan, Josephine M, van der Lely, Aart J·2018·The Lancet Diabetes & Endocrinology

DOI 10.1016/s2213-8587(18)30026-3PMC PMC6089223

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Abstract

During ageing, the secretory patterns of the hormones produced by the hypothalamic–pituitary axis change, as does the sensitivity of the axis to negative feedback by end hormones. Additionally, glucose homoeostasis tends towards disequilibrium with increasing age. Along with these endocrine alterations, a loss of bone and muscle mass and strength occurs, coupled with an increase in fat mass. In addition, ageing-induced effects are difficult to disentangle from the influence of other factors that are common in older people, such as chronic diseases, inflammation, and low nutritional status, all of which can also affect endocrine systems. Traditionally, the decrease in hormone activity during the ageing process has been considered to be detrimental because of the related decline in bodily functions. The concept of hormone replacement therapy was suggested as a therapeutic intervention to stop or reverse this decline. However, clearly some of these changes are a beneficial adaptation to ageing, whereas hormonal intervention often causes important adverse effects. In this paper, we discuss the effects of age on the different hypothalamic–pituitary–hormonal organ axes, as well as age-related changes in calcium and bone metabolism and glucose homoeostasis.

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FPG does not increase significantly after age 60, but 2-h glucose concentrations during a 75-g OGTT are considerably higher in older people.
“FPG does not increase significantly after age 60, but 2-h glucose concentrations during a 75-g OGTT are considerably higher in older people (98,99).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [98]
The Glucose homoeostasis section reports that glucose concentrations two hours after a 75-g oral glucose tolerance test gradually increase with age. It does not describe that increase as considerable; it also reports that fasting plasma glucose rises by approximately 0.055 mmol/L per decade, without stating that the rise becomes statistically insignificant after age 60. No page number is available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured
FPG increases with increasing age beginning in the third to fourth decade.
“FPG increases with increasing age beginning in the third to fourth decade (97,98).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [98]
Glucose homeostasis is impaired with aging.
“Glucose homeostasis is impaired with aging.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [98]
During ageing, hormones including gonadal hormones, glucocorticoids, thyroid hormones and insulin are perturbed due to dysregulation of the hypothalamic-pituitary-gonadal, hypothalamic-pituitary-adrenal and hypothalamic-pituitary-thyroid axes, leading to age-related diseases.
“During the ageing process, these hormones are perturbed due to dysregulation of the major endocrine axes, including the hypothalamic–pituitary–gonadal (HPG) axis, hypothalamic–pituitary–adrenal (HPA) axis and hypothalamic–pituitary–thyroid (HPT) axis, leading to age-related diseases.349”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [349]
Regulating hormone levels appropriately to adapt to age-related changes is advantageous in delaying age-related diseases.
“regulating hormone levels appropriately to adapt to age-related changes is advantageous in delaying age-related diseases.349”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [349]

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Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus
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Hormones in aging
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Authors: van den Beld, A. W., Kaufman, J.-M., Zillikens, M. C., Lamberts, S. W. J., Egan, J. M., & van der Lely, A. J.
Affiliations: Ghent University Hospital (BE)
Erasmus MC (NL)
National Institute on Aging (US)
ORCID: Kaufman, Jean-Marc
Zillikens, M Carola
Egan, Josephine M
Venue: The Lancet Diabetes & Endocrinology
Publisher: Elsevier BV
Published: 2018-08
Volume: 6
Issue: 8
Pages: 647-658
ISSN: 2213-8587 (ISSN-L)
DOI: 10.1016/s2213-8587(18)30026-3
PMC: PMC6089223
OpenAlex: W2883912013
Semantic Scholar: e8e5b512ecbd62d13552ce938b6e72b7211d458a
Cited by: 349
References: 123
Citations by year: 2026: 37 · 2025: 45 · 2024: 63 · 2023: 68 · 2022: 43 · 2021: 55 · 2020: 21 · 2019: 14 · 2018: 2 · 2016: 1
FWCI: 3.54
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Diabetes & Endocrinology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Funders: National Institutes of Health (Z99 AG999999)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: aging, endocrine system, hypothalamic-pituitary axis, negative feedback, glucose homeostasis, bone loss, muscle mass and strength, fat mass, chronic disease, inflammation, nutritional status, hormone replacement therapy, adverse effects
MeSH terms: Aging, Endocrine System, Hormones, Humans

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