Endocrine Disorders

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk


With ageing, few morphological changes have been reported in the pancreas which include a degree of atrophy, fatty infiltration and fibrosis and the presence of amyloid material and lipofuscin granules. The age-related decline in glucose handling seems to result from insulin resistance rather than an impairment of insulin secretion. Possible explanations for this age-related insulin resistance include various factors such as fat mass, fat distribution, dietary composition, physical activity and capacity of glucose uptake. Long-standing diabetes is associated with damage and dysfunction of large (macrovascular) and small (microvascular) blood vessels resulting in damage to various organs. Microvascular dysfunction occurs early in diabetes and parallels progression of neural dysfunction. With ageing, the number and size of thyroid follicles and the colloid content decrease. There is lymphocytic infiltration and fibrosis of the connective tissue on histological examination. Serum levels of thyroid hormones change little with age. TSH changes during healthy ageing are equivocal but typically remains normal except for a mild decrease in extreme senescence. There is an elevation of thyroid antibodies with ageing, but this increase appears to be related to age-associated diseases rather than to ageing per se. In the elderly thyroid function tests may be influenced by illness, malnutrition and medication. T4 production declines with advancing age, but serum T4 (total and free) concentrations remain unchanged. The parathyroid hormone level increases with age, but the calcitonin level seems to decrease with age. Patients with primary hyperparathyroidism (PHPT) have an increased bone turnover and decreased BMD associated with low vitamin D states and high plasma 1,25(OH) D.


Age-related changes Age-related insulin resistance Thyroid follicles Thyrotropic-stimulating hormone Parathyroid hormone 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 2
  • Gary Cheuk
    • 3
  1. 1.Sydney Medical School (Westmead)The University of SydneyNorth RocksAustralia
  2. 2.Norwest Specialist Medical GroupBella VistaAustralia
  3. 3.Blacktown-Mt Druitt HospitalBlacktownAustralia

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