Oral dehydroepiandrosterone replacement in older adults: effects on central adiposity, glucose metabolism and blood lipids.

Abstract

To determine the effects of dehydroepiandrosterone (DHEA) therapy on changes in central adiposity, insulin action and blood lipids. Many of the actions of DHEA in humans are thought to be mediated through its conversion to sex hormones, which are modulators of adiposity, muscularity and insulin sensitivity. The effects of DHEA replacement on regional tissue composition, glucose metabolism and blood lipid profile in older adults have been inconsistent. A randomized, double-blinded, placebo-controlled trial. The intervention was oral DHEA 50 mg/day or placebo for 12 months. Fifty-eighty women and 61 men, aged 60-88 years, with low serum DHEA sulphate (DHEAS) levels at study entry. Computed tomography measures of abdominal fat areas, thigh muscle and fat areas, DXA-derived trunk fat mass, serum glucose and insulin responses to an oral glucose challenge, and fasted serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were assessed before and after the intervention. There were no significant (P > 0·05) differences between the DHEA and placebo groups in the changes in regional tissue composition or glucose metabolism. HDL-cholesterol (P = 0·01) and fasted triglycerides (P = 0·02) decreased in women and men taking DHEA. Restoring serum DHEAS levels in older adults to young adult levels for 1 year does not appear to reduce central adiposity or improve insulin action. The benefit of DHEA on decreasing serum triglycerides must be weighed against the HDL-lowering effect.