Untersuchung der zirkadianen Rhythmik des Cortisols im Alter anhand der populationsbasierten Studien KORA-Age I & II

Pflüger, Laurenz (2019): Untersuchung der zirkadianen Rhythmik des Cortisols im Alter anhand der populationsbasierten Studien KORA-Age I & II. Dissertation, LMU München: Faculty of Medicine

Abstract

Context: Disorders in the elderly are common with syndromes of hypercortisolism. But data on “normal” cortisol in the aged are missing, making the diagnosis of hypercortisolism a challenge. Objective: To assess potential alteration of cortisol in high age. Design: KORA-Age is a cross sectional longitudinal study conducted 2008-2011 and 2011-2014. Setting: Subjects received test kits for salivary sampling at home according to individual diurnal rhythm for hormone measurement. Patients: Subjects were randomly recruited in Augsburg, equally distributed between sexes, in KA-I n=820 (age 65-90, mean 75) and in KA-II n=690 (age 68-92, mean 77). In KA-II n=485 were participants of KA-I, the rest was newly recruited. Intervention: Subjects with glucocorticoid treatment and those who smoked close to sampling time were excluded. Main Outcome Measure: The studies demonstrate an increase in LNSC associated to higher age. The morning cortisol level was not altered by age. Results: 11.0% (KA-I) and 14.3% (KA-II) of the subjects had LNSC above Cushing cut-off (> 1.5 ng/mL). Median LSCN was higher (p<0.001) in the oldest group (81-90 years in KA-I (n=144), 83-92 years in KA-II (n=144)) compared to the youngest (65-70 years (n= 211) and 68-72 years (n=158)). Outliers (> 1.5 ng/mL) raised from 8.0% (65-70 y) to 16.7% in KA-I (p<0,05) and from 7.0% (68-72 years) to 21.5% (83-92 years) in KA-II (p<0.01). Median LSCN of subjects in longitudinal observation (n=485) raised within 2-3 years from 0.6 to 0.8 ng/mL (p<0.0001). Conclusions: LNSC in the elderly must be considered when applying traditional cut-off values during screening for Cushing's syndrome in aged population.

• Item Type: Theses (Dissertation, LMU Munich)
• Keywords: Cortisol, KORA-Age, late night salivary cortisol, hypercortisolism, Cushing
• Subjects: 600 Technology, Medicine; 600 Technology, Medicine > 610 Medical sciences and medicine
• Faculties: Faculty of Medicine
• Language: German
• Date of oral examination: 7. February 2019
• 1. Referee: Reincke, Martin
• Signature of the printed copy: 0700/UMD 18434