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Postmenopausal dehydroepiandrosterone administration increases free insulin-like growth factor-I and decreases
P R Casson1, N Santoro, K Elkind-Hirsch
1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA. PCASSON@BCM.TMC.EDU
Objective:
To determine the effect of administering 6 months of oral postmenopausal DHEA therapy on serum DHEA, DHEAS, and T levels and on physiologic endpoints including lipoproteins and insulin-like growth factor-I (IGF-I).
Design:
Randomized, double-blind, parallel trial.
Setting:
Academic referral practice.
Patient(S):
Thirteen normal-weight or overweight, healthy, nonsmoking, postmenopausal women.
Intervention(S):
Administration of oral micronized DHEA (25 mg/d).
Main Outcome Measure(S):
Monthly fasting 23 hours postdose levels of serum DHEA, DHEAS, T, lipoproteins, IGF-I, IGF binding protein-3 (IGFBP-3), and liver function tests. Morphometric indices by dual-energy x-ray absorptiometry scan (percent body fat; lean body mass), immune indices, and insulin sensitivity.
Result(S):
Levels of DHEA, DHEAS, and T all rose into premenopausal ranges, but after 6 months, levels of DHEA and T did not differ from baseline or placebo. At 3 months, the ratio of IGF-I to IGFBP-3 rose by 36.1% +/- 12.7%, but it fell to placebo values by 6 months. High-density lipoprotein and apolipoprotein A1 levels declined.
Conclusion(S):
Patients appeared to tolerate 6 months of DHEA therapy well. Given the small study size, no statistically significant differences in morphometric indices, immune indices, or insulin-sensitizing properties were observed, but significant attenuation of bioavailability occurred. Supplementation with DHEA increased IGF-I/IGFBP-3 levels at 3 months and decreased high-density lipoprotein and apolipoprotein A1 levels at 6 months.