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YAŞLI POPÜLASYONDA HİPOTALAMOPİTÜİTER AKS DEĞİŞİKLİKLERİ



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YAŞLI POPÜLASYONDA HİPOTALAMOPİTÜİTER AKS DEĞİŞİKLİKLERİ 
Yaşlı hastalarda Büyüme hormonu tedavisinin gerekliliği tartışmalıdır. Yaşlı popülasyonda 
BH’nun güvenirliği ile ilgili yeterli veri yoktur. Eğer replasman yapılacaksa BH normal erişkin 
dozunun yarısı dozunda başlanmalı ve 4-6 haftada bir IGF-1 düzeyleri değerlendirilerek doz titre 
edilmelidir (32). 
Kaynaklar
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mic-pituitary-adrenal axis: pathophysiological correlates. Eur J Endocrinol 2001;144:319-29.
2.  Veldhuis JD, Sharma A, Roelfsema F. Age-dependent and gender-dependent regulation of hypothalamic-adrenocor-
ticotropic-adrenal axis. Endocrinol Metab Clin North Am 2013;42:201-25.
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a longitudinal study of a community-based cohort. J Clin Endocrinol Metab 2012;97:1554-62.
6.  Waring AC, Arnold AM, Newman AB, Buzkova P, Hirsch C, Cappola AR. Longitudinal changes in thyroid 
function in the oldest old and survival: the cardiovascular health study all-stars study. J Clin Endocrinol Metab 
2012;97:3944-50.
7.  Gregerman RI, Gaffney GW, Shock NW, Crowder SE. Thyroxine turnover in euthyroid man with special reference 
to changes with age. J Clin Invest 1962;41:2065-74.
8.  Veldhuis JD. Changes in pituitary function with ageing and implications for patient care. Nat Rev Endocrinol 
2013;9:205-15.
9.  Veldhuis JD, Anderson SM, Shah N, Bray M, Vick T, Gentili A, et al. Neurophysiological regulation and target-tis-
sue impact of the pulsatile mode of growth hormone secretion in the human. Growth Horm IGF Res 2001;11 Suppl 
A:S25-37.
10.  Nass R. Growth hormone axis and aging. Endocrinol Metab Clin North Am 2013;42:187-99.
11.  Camacho EM, Huhtaniemi IT, O’Neill TW, Finn JD, Pye SR, Lee DM, et al. Age-associated changes in hypothala-
mic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: 
longitudinal results from the European Male Ageing Study. Eur J Endocrinol 2013;168:445-55.
12.  Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD, et al. Age trends in the level of serum 
testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. 
J Clin Endocrinol Metab 2002;87:589-98.
13.  Rubens R, Dhont M, Vermeulen A. Further studies on Leydig cell function in old age. J Clin Endocrinol Metab 
1974;39:40-5.
14.  Araujo AB, Wittert GA. Endocrinology of the aging male. Best Pract Res Clin Endocrinol Metab 2011;25:303-19.
15.  Veldhuis JD, Keenan DM, Liu PY, Iranmanesh A, Takahashi PY, Nehra AX. The aging male hypothalamic-pitui-
tary-gonadal axis: pulsatility and feedback. Mol Cell Endocrinol 2009;299:14-22.
16.  Mahmoud AM, Goemaere S, De Bacquer D, Comhaire FH, Kaufman JM. Serum inhibin B levels in commu-
nity-dwelling elderly men. Clin Endocrinol (Oxf ) 2000;53:141-7.
17.  Gill S, Lavoie HB, Bo-Abbas Y, Hall JE. Negative feedback effects of gonadal steroids are preserved with aging in 
postmenopausal women. J Clin Endocrinol Metab 2002;87:2297-302.
18.  Shaw ND, Srouji SS, Histed SN, Hall JE. Differential effects of aging on estrogen negative and positive feedback. 
Am J Physiol Endocrinol Metab 2011;301:E351-5.
19.  Chappel SC, Ulloa-Aguirre A, Coutifaris C. Biosynthesis and secretion of follicle-stimulating hormone. Endocr Rev 
1983;4:179-211.
20.  Hall JE, Lavoie HB, Marsh EE, Martin KA. Decrease in gonadotropin-releasing hormone (GnRH) pulse frequency 
with aging in postmenopausal women. J Clin Endocrinol Metab 2000;85:1794-800.
21.  Curto L, Trimarchi F. Hypopituitarism in the elderly: a narrative review on clinical management of hypothalamic-pi-
tuitary-gonadal, hypothalamic-pituitary-thyroid and hypothalamic-pituitary-adrenal axes dysfunction. J Endocrinol 
Invest 2016;39:1115-24.
22.  Aimaretti G, Ambrosio MR, Di Somma C, Fusco A, Cannavo S, Gasperi M, et al. Traumatic brain injury and suba-
rachnoid haemorrhage are conditions at high risk for hypopituitarism: screening study at 3 months after the brain 
injury. Clin Endocrinol (Oxf ) 2004;61:320-6.


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