Increases in bone mineral density in response to oral dehydroepiandrosterone replacement in older adults appear to be mediated by serum estrogens.
J Clin Endocrinol Metab
; 93(12): 4767-73, 2008 Dec.
Article
em En
| MEDLINE
| ID: mdl-18812486
ABSTRACT
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, ANDPARTICIPANTS:
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 OUTCOMEMEASURES:
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 PCONCLUSIONS:
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Densidade Óssea
/
Sulfato de Desidroepiandrosterona
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Terapia de Reposição Hormonal
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Estrogênios
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article