Zusammenfassung
Der als Somatopause, Menopause bzw. Andropause bezeichnete Abfall der Serumkonzentration von Wachstumshormonen und Sexualsteroiden im Alter ist mit Veränderungen der Körperzusammensetzung und von kognitiven wie physischen Fähigkeiten verbunden, die mit selektiven Störungen der jeweiligen Hormonachsen in der Jugend gut vergleichbar sind. Da eine Hormonersatztherapie die Symptomatik zumindest teilweise normalisieren kann, ist diskutiert worden, dass auch Alterungsvorgänge wesentlich durch die Veränderung der humoralen Steuerung beeinflusst werden. Sowohl der Ausfall der somatotropen wie der gonadotropen Achse führt in der Jugend zu einem Abbau der Muskulatur und einer Zunahme der Körperfettmasse. Vergleichbare Verschiebungen der Körperzusammensetzung finden sich bei physiologischen Alterungsvorgängen, welche bereits in der 2. bis 3. Lebensdekade erkennbar sind. Dies wird belegt durch Querschnittsuntersuchungen wie das Monica-Projekt, aber auch durch Longitudinalstudien (Mayo Clinic, Baltimore, Longitudinal Study on Ageing), in deren Verlauf gesunde Erwachsene über mehrere Jahrzehnte hinsichtlich ihrer Körperzusammensetzung mit sehr präzisen Messmethoden untersucht wurden (Forbes u. Reina 1970, Liese et al. 2001, Metter et al. 2002, Roy et al. 2002). Als Ergebnis dieser verschiedenen Ansätze fand sich eine Abnahme der Muskelmasse zwischen dem 20. und 60. Lebensjahr von 5–10 kg bei einem Gewichtsanstieg von insgesamt 10–15 kg. Diese Daten unterstützen die deutliche Verschiebung der Körperzusammensetzung mit einem erheblichen Verlust von Muskelmasse und einer ausgeprägten Akkumulation von Körperfett im physiologischen Alterungsprozess. Eng mit der Verminderung der Muskelmasse ist auch eine Verschlechterung der Muskelfunktion verbunden, welche die Gebrechlichkeit alter Menschen erhöht, Stürze leichter möglich macht und damit eine Pflegeabhängigkeit bei älteren Menschen auslösen kann. Ziel der vorliegenden Übersicht soll es sein, die Veränderung der Sexualsteroide beim Mann, der Wachstumshormonachse und von metabolischen Vorgängen in der altersspezifischen Physiologie mit Bezug auf die bisher bekannten molekularen Mechanismen darzustellen.
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Behrends, J., Brabant, G. (2004). Molekulare Grundlagen altersspezifischer Erkrankungen des Endokriniums. In: Ganten, D., Ruckpaul, K., Ruiz-Torres, A. (eds) Molekularmedizinische Grundlagen von altersspezifischen Erkrankungen. Molekulare Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18741-4_10
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