Bone mineral density and osteoporosis among a predominantly Caucasian elderly population in the city of São Paulo, Brazil.

This cross-sectional study covered 301 individuals over 70 years of age--207 women (W) and 94 men (M)--living in the city of São Paulo, Brazil. Our aims were to evaluate the prevalence of low bone mineral density (BMD) in this population and the possible factors that influence BMD. The subjects were submitted to a bone densitometry scan (DXA) to evaluate the BMD at lumbar spine (LS), femoral neck (FN), trochanter (T), total femur (TF) and total body composition. At the time, the participants filled in a questionnaire about lifestyle habits, diet and medical history, as well as having blood samples taken to check hormone and biochemical levels. Anthropometric parameters were measured. Osteopenia and osteoporosis were defined in accordance with the criteria suggested by the World Health Organization. In the different sites studied, the prevalence of osteopenia and osteoporosis varied, in men ranging 33.3-57.4% and 6.4-16.1%, respectively, and in women ranging 36.6-56.5% and 22.2-33.2%, respectively. Weight was the variable that most strongly correlated with BMD at the proximal femur in both sexes (men, r =0.44-0.52; women, r =0.48-0.52) and with BMD at LS in women (r =0.44). Height was the parameter that best correlated with BMD at LS in men (r =0.34). In men follicle-stimulating hormone, growth hormone and glycemia correlated with BMD at T and TF, while plasma albumin only correlated with BMD at T. In women glycemia correlated with BMD at LS, and follicle-stimulating hormone correlated with BMD at FN, T and TF. In conclusion, we found a high prevalence of osteopenia and osteoporosis in this population, with weight being the best predictor of BMD. The prevalence of osteoporosis and osteopenia at FN was as high in men as that observed in women.

The effect of hospitalization on the sleep pattern and on cortisol secretion of healthy elderly.

The aim of this study was to verify whether polysomnography represents a stressful situation by assessing cortisol levels and the sleep pattern of healthy community-living elderly admitted to a sleep disorder center (SDC). Subjects slept for two sequential nights at the SDC for polysomnographic recordings. Blood was sampled at 0800 h, 1600 h, and 2300 h and 24-h urine was collected for cortisol determination. Three months later, subjects were visited at home for blood and urinary collections. Cortisol levels were higher in the SDC than at home at 0800 h but were lower at 2300 h and similar at 1600 h. No differences were observed in urinary cortisol. Polysomnographic recordings indicated a poorer sleep pattern in the first night. Our data indicate that a short-term stay of healthy elderly in a SDC disrupts sleep pattern in the first of 2 nights, without representing a stressful experience, as evaluated by cortisol levels.

Urinary free cortisol is similar in older and younger women.

The increased cortisol secretion that occurs with aging is associated with characteristics of frailty. In this study we investigated whether healthy elderly women excrete increased amounts of urinary free cortisol (UFC) when compared to younger women. Twenty-four-hour UFC levels were measured in 25 elderly (70 to 87 years of age; median: 74) and 24 younger (19 to 59 years of age; median: 46) community-living women. All subjects were healthy and cognition was unimpaired. No differences in 24-hr UFC were observed between elderly and younger women (54.2 +/- 28.0 and 45.1 +/- 15.6 micrograms/24 hr, respectively) and no correlation was found between 24-hr UFC and age. Also, elderly and younger women had similar 24-hr urinary volumes (1366 +/- 531 and 1514 +/- 412 ml 24 hr, respectively) that did not correlate with UFC. In conclusion, older and younger healthy women have similar 24-hr UFC levels, possibly reflecting a comparable adrenocortical secretion of cortisol.

Níveis séricos de hormônios de crescimento, fator de crescimento símile à insulina e sulfato de deidroepiandrosterona em idosos residentes na comunidade: correlaçäo com parâmetros clínicos / Serum levels of growth hormone, insulin like growth factor and dehydroepiandrosterone sulfate in elderly people living in the community: correlation with clinical parameters

O envelhecimento é acompanhado de alteraçöes orgânicas possivelmente relacionadas com o sistema endócrino. O eixo GH/IGF-1 e a produçäo de SDHEA declinam com a idade, caracterizando uma reduçäo de suas atividades, que podem resultar em efeitos deletérios sobre a composiçäo corporal, o sistema cardiovascular e a congniçäo. Avaliamos a concentraçäo sérica basal de GH, IGF-1 e SDHEA em 225idosos de uma comunidade (148 mulheres e 77 homens, 70 a 91 anos), 80 por cento deles com características de envelhecimento bem sucedido (Minimental >/= 3). Tanto o IMC como a pressäo arterial estavam significativamente mais elevados nas mulheres. Os níveis de GH também eram amiores nas mulheres (1,6 +/- 1,7 vs. 1,0 +/- 1,3 ng/ml, X +/- DP, p<0,001), estando acima da faixa de referência em 14 por cento e 19 por cento das mulheres e homens. Já os níveis de IGF-1 eram semelhantes (90 +/- 42 e 101 +/- 40ng/ml, NS), nao sendo elevados em nenhum deles e reduzidos em 35 por cento e 24 por cento, respectivamente. Os níveis de SDHEA eram maiores nos homens (86 +/- 58 e 54 +/- 36µg/dl, p<0,001), porém na faixa de referência em 92 por cento deles. Houve uma surpreendente correlaçäo positiva entre idade e GH nos homens (r= 0,38, p<0,005), mas uma correlaçäo negativa entre IGF-1 e idade nos dois grupos r= -0,24 e r= -0,32). Nas mulheres, houve também uma correlaçäo positiva entre SDHEA e IGF-1 (r= 0,27). Em conclusäo, níveis basais de GH podem estar elevados em uma parcela significativa dos idosos, sendo maiores nas mulheres, enquanto os níveis de IGF-1 encontram-se normais ou baixos nos dois grupos, sugerindo quadro de resistência hormonal. Os níveis de SDHEA encontravam-se na faixa de referência, sendo maiores nos homens, caracterizandoa perda da contribuiçäo oariana. Diferentemente do que se tem especulado, näo encontramos correlaçäo entre os níveis de SDHEA e qualquer parâmetro clínico investigado.

Envelhecimento e funçäo adrenocortical / Aging and adrenal cortex function

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