Effects of dehydroepiandrosterone sulphate (DHEAS) replacement on insulin action and quality of life in hypopituitary females: a double‐blind, placebo‐controlled study

Abstract

Addition of dehydroepiandrosterone sulphate (DHEAS) to standard pituitary replacement may improve quality of life and glucose metabolism. Conflicting results from the previous work probably relate to differences in populations studied and assessment techniques used. We examined the effects of DHEAS on insulin action and the quality of life in female patients with hypopituitary hypoadrenalism. Randomized, double-blind, placebo-controlled, crossover design was used. Patients received either DHEAS 50mg daily or placebo for 12weeks. Fourteen hypopituitary females on stable standard replacement therapy and with low DHEAS were enrolled. Insulin action by euglycaemic hyperinsulinaemic clamp and extensive quality of life parameters were assessed after each treatment. Serum DHEAS (DHEAS 5·4±0·8 vs placebo <0·8± 0·0μm; P<0·001) and androstenedione (DHEAS 4·1±0·8 vs placebo 1·3±0·2nm; P<0·05) rose to within the normal range after DHEAS 50mg daily. There were no differences between treatments in testosterone, sex hormone-binding globulin (SHBG) or IGF-1. Quality of life measures were unchanged after DHEAS. There were no differences between treatments in fasting glucose, serum insulin, HbA1c or in insulin action (glucose infusion rates required to maintain euglycaemia; DHEAS 21·9±2·5 vs placebo 24·5±2·1μmol/kg/min; P=0·4). Triglyceride concentrations were lower following DHEAS (DHEAS 1·24±0·18 vs placebo 1·41±0·19mm; P<0·05) but other lipid parameters remained unchanged. There were no differences compared with placebo in quality of life or insulin action after DHEAS replacement therapy for 12weeks. These results do not provide evidence for the addition of DHEAS to standard hypopituitary replacement therapy.