Abstract
The pancreas is a vital organ which has both endocrine and exocrine functions and plays an essential role in food digestion and glucose metabolism. Pancreatic structure and function undergo a series of changes with aging and senescence. Pancreatic exocrine and endocrine function gradually change, which may lead to conditions such as dyspepsia and diabetes mellitus. Hence, clinicians need to be familiar with the characteristics of pancreatic senescence. This article reviews the manifestations of pancreatic senescence and its significance for clinical practice.
Highlights
The pancreas is situated deep in the retroperitoneum and has a complex histology, characterized by the unusual situation of endocrine and exocrine cells coexisting in the same organ
Another study measured the level of fecal elastase-1 (FE-1) in 1105 patients without pancreatic disease but with symptoms of dyspepsia; the results showed that the level of FE-1 was less than 200 μg/g in 10% of the elderly aged >70 years old, and 70 years.[24]
Laugier et al collected the duodenal fluid of 180 subjects aged 16-83 with no pancreatic disease after intravenous injection of secretin to evaluate pancreatic exocrine function, the results of which showed that duodenal fluid production after the TA B L E 1 Age related changes in pancreas
Summary
The pancreas is situated deep in the retroperitoneum and has a complex histology, characterized by the unusual situation of endocrine and exocrine cells coexisting in the same organ. In vitro experiments using cells separated from rat islets found that both GSIR (glucose-stimulated insulin release) and PSIR (palmitic acid-stimulated insulin release) reduced with senescence.[16] A Chinese study has suggested that both the basic secretion function of beta cells in rat islets and the secretion function after glucose stimulation decreases with age, accompanied by decrease of the insulin secretion peak and a gradually delayed peaking time, manifesting as obvious impaired glucose tolerance.[17] Muller et al performed an oral glucose tolerance test (OGTT) in 771 subjects aged from 20 to 96 years; those who took drugs or suffered from an illness which might affect glucose tolerance had been excluded They found that blood insulin levels significantly decreased with increasing age, and the average insulin levels are 323, 267, 253 and 228 pM at ages 2039, 40-59, 60-79 and 80-96 years, respectively, after the correction of relevant factors (P < .01).[18]. Laugier et al collected the duodenal fluid of 180 subjects aged 16-83 with no pancreatic disease after intravenous injection of secretin to evaluate pancreatic exocrine function, the results of which showed that duodenal fluid production after the
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