CONTEXT: The mechanisms by which dehydroepiandrosterone (DHEA) replacement increases bone mineral density (BMD) in older adults are not known. OBJECTIVE: The aims were to determine the effects of DHEA therapy on changes in sex hormones and IGF-I and their associations with changes in BMD. DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blinded, placebo-controlled trial was conducted at an academic research institution. Participants were 58 women and 61 men, aged 60-88 yr, with low serum DHEA sulfate (DHEAS) levels. INTERVENTION: The intervention was oral DHEA 50 mg/d or placebo for 12 months. MAIN OUTCOME MEASURES: BMD and serum DHEAS, testosterone, estradiol (E(2)), estrone (E(1)), SHBG, IGF-I, and IGF binding protein 3 were measured before and after intervention. Free testosterone and estrogen (FEI) indices were calculated. RESULTS: The average changes in hip and spine BMD (DHEA vs. placebo) ranged from 1.1 to 1.6%. Compared with placebo, DHEA replacement increased serum DHEAS, testosterone, free testosterone index, E(1), E(2), FEI, and IGF-I (all P < 0.001) and decreased SHBG (P = 0.02) in women and, in men, increased DHEAS, E(1), FEI (all P < 0.001), and E(2) (P = 0.02) and decreased SHBG (P = 0.037). The changes in total and regional hip BMD were associated with 12-month E(2) (all P <or= 0.001) and FEI (all P <or= 0.013). The effects of DHEA treatment were eliminated by adjustment for 12-month E(2). CONCLUSIONS: The significant increases in hip BMD in older adults undergoing DHEA replacement were mediated primarily by increases in serum E(2) rather than direct effects of DHEAS.
RCT Entities:
CONTEXT: The mechanisms by which dehydroepiandrosterone (DHEA) replacement increases bone mineral density (BMD) in older adults are not known. OBJECTIVE: The aims were to determine the effects of DHEA therapy on changes in sex hormones and IGF-I and their associations with changes in BMD. DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blinded, placebo-controlled trial was conducted at an academic research institution. Participants were 58 women and 61 men, aged 60-88 yr, with low serum DHEA sulfate (DHEAS) levels. INTERVENTION: The intervention was oral DHEA 50 mg/d or placebo for 12 months. MAIN OUTCOME MEASURES: BMD and serum DHEAS, testosterone, estradiol (E(2)), estrone (E(1)), SHBG, IGF-I, and IGF binding protein 3 were measured before and after intervention. Free testosterone and estrogen (FEI) indices were calculated. RESULTS: The average changes in hip and spine BMD (DHEA vs. placebo) ranged from 1.1 to 1.6%. Compared with placebo, DHEA replacement increased serum DHEAS, testosterone, free testosterone index, E(1), E(2), FEI, and IGF-I (all P < 0.001) and decreased SHBG (P = 0.02) in women and, in men, increased DHEAS, E(1), FEI (all P < 0.001), and E(2) (P = 0.02) and decreased SHBG (P = 0.037). The changes in total and regional hip BMD were associated with 12-month E(2) (all P <or= 0.001) and FEI (all P <or= 0.013). The effects of DHEA treatment were eliminated by adjustment for 12-month E(2). CONCLUSIONS: The significant increases in hip BMD in older adults undergoing DHEA replacement were mediated primarily by increases in serum E(2) rather than direct effects of DHEAS.
Authors: Burkhard Lorenz Herrmann; Bernhard Saller; Onno Eilard Janssen; Peter Gocke; Andreas Bockisch; Herbert Sperling; Klaus Mann; Martina Broecker Journal: J Clin Endocrinol Metab Date: 2002-12 Impact factor: 5.958
Authors: E E Baulieu; G Thomas; S Legrain; N Lahlou; M Roger; B Debuire; V Faucounau; L Girard; M P Hervy; F Latour; M C Leaud; A Mokrane; H Pitti-Ferrandi; C Trivalle; O de Lacharrière; S Nouveau; B Rakoto-Arison; J C Souberbielle; J Raison; Y Le Bouc; A Raynaud; X Girerd; F Forette Journal: Proc Natl Acad Sci U S A Date: 2000-04-11 Impact factor: 11.205
Authors: Catherine M Jankowski; Pamela Wolfe; Sarah J Schmiege; K Sreekumaran Nair; Sundeep Khosla; Michael Jensen; Denise von Muhlen; Gail A Laughlin; Donna Kritz-Silverstein; Jaclyn Bergstrom; Richele Bettencourt; Edward P Weiss; Dennis T Villareal; Wendy M Kohrt Journal: Clin Endocrinol (Oxf) Date: 2018-12-09 Impact factor: 3.478
Authors: Aviva B Sopher; Amy M Jean; Sarah K Zwany; Diana M Winston; Christy B Pomeranz; Jennifer J Bell; Donald J McMahon; Abeer Hassoun; Ilene Fennoy; Sharon E Oberfield Journal: Obesity (Silver Spring) Date: 2011-02-10 Impact factor: 5.002
Authors: Amy D Divasta; Henry A Feldman; Courtney Giancaterino; Clifford J Rosen; Meryl S Leboff; Catherine M Gordon Journal: Metabolism Date: 2012-01-16 Impact factor: 8.694
Authors: Catherine M Jankowski; Wendolyn S Gozansky; Rachael E Van Pelt; Pamela Wolfe; Robert S Schwartz; Wendy M Kohrt Journal: Clin Endocrinol (Oxf) Date: 2011-10 Impact factor: 3.478
Authors: Kerry L Hildreth; Daniel W Barry; Kerrie L Moreau; Joseph Vande Griend; Randall B Meacham; Tammie Nakamura; Pamela Wolfe; Wendy M Kohrt; J Mark Ruscin; John Kittelson; M Elaine Cress; Robert Ballard; Robert S Schwartz Journal: J Clin Endocrinol Metab Date: 2013-03-26 Impact factor: 5.958
Authors: Sybil Crawford; Nanette Santoro; Gail A Laughlin; Mary Fran Sowers; Daniel McConnell; Kim Sutton-Tyrrell; Gerson Weiss; Marike Vuga; John Randolph; Bill Lasley Journal: J Clin Endocrinol Metab Date: 2009-05-26 Impact factor: 5.958
Authors: Dirk Vanderschueren; Michaël R Laurent; Frank Claessens; Evelien Gielen; Marie K Lagerquist; Liesbeth Vandenput; Anna E Börjesson; Claes Ohlsson Journal: Endocr Rev Date: 2014-09-09 Impact factor: 19.871