中国肾上腺衰老诊疗专家共识(2025版)

doi:10.3969/j.issn.1003-9198.2026.04.020

Abstract

Abstract: Adrenal aging refers to the progressive structural and functional changes of the adrenal glands that occur with advancing age, particularly characterized by a remodeling of the adrenal cortical secretory profile with a marked decline in dehydroepiandrosterone (DHEA) and its sulfate (DHEAS), a decrease in average aldosterone levels, and overall cortisol levels that remain relatively stable or are mildly elevated, with attenuation of circadian rhythms and secretory pulse amplitudes. These hormonal changes are associated with adverse outcomes across multiple systems, including sarcopenia/osteopenia, metabolic syndrome, blood pressure abnormalities, impaired immune function, mood and cognitive disorders, frailty, and reduced rehabilitation capacity, indicating that adrenal aging is a clinical issue warranting attention. However, there has been no unified national consensus or guideline in China on adrenal aging/adrenocortical aging to date. Based on a systematic review of the evidence and aligned with domestic clinical practice, this consensus for the first time proposes the definition of adrenal aging, pathways for diagnostic evaluation, recommendations for laboratory and imaging tests, key points for differential diagnosis, stratified management and intervention strategies, and follow-up standards, with the goal of standardizing clinical diagnosis, treatment, and research practice related to adrenal aging in China and promoting healthy aging.

Key words: adrenal gland, aging, adrenal cortex, cortisol, aldosterone, circadian rhythm, frailty

CLC Number:

Expert Consensus Panel on Adrenal Aging, Geriatric Medicine Branch, Chinese Association of Rehabilitation Medicine. Expert consensus on the diagnosis and management of adrenal aging in China (2025 Edition)[J]. Practical Geriatrics, 2026, 40(4): 433-444.

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Expert consensus on the diagnosis and management of adrenal aging in China (2025 Edition)

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