title: The Role of the Multiple Hormonal Dysregulation in the Onset of "Anemia of Aging": Focus on Testosterone, IGF-1, and Thyroid Hormones.
abstract: Anemia is a multifactorial condition whose prevalence increases in both sexes after the fifth decade of life. It is a highly represented phenomenon in older adults and in one-third of cases is "unexplained." Ageing process is also characterized by a "multiple hormonal dysregulation" with disruption in gonadal, adrenal, and somatotropic axes. Experimental studies suggest that anabolic hormones such as testosterone, IGF-1, and thyroid hormones are able to increase erythroid mass, erythropoietin synthesis, and iron bioavailability, underlining a potential role of multiple hormonal changes in the anemia of aging. Epidemiological data more consistently support an association between lower testosterone and anemia in adult-older individuals. Low IGF-1 has been especially associated with anemia in the pediatric population and in a wide range of disorders. There is also evidence of an association between thyroid hormones and abnormalities in hematological parameters under overt thyroid and euthyroid conditions, with limited data on subclinical statuses. Although RCTs have shown beneficial effects, stronger for testosterone and the GH-IGF-1 axis and less evident for thyroid hormones, in improving different hematological parameters, there is no clear evidence for the usefulness of hormonal treatment in improving anemia in older subjects. Thus, more clinical and research efforts are needed to investigate the hormonal contribution to anemia in the older individuals.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy; Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maggio
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Vita
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fisichella
authors.affiliation: Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ticinesi
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy; Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Ceresini
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Cappola
authors.affiliation: National Institute on Aging, National Institutes of Health (NIH), Baltimore, MD 21201, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, 43126 Parma, Italy; Geriatric Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ceda