| Dehydroepiandrosterone substitution in female adrenal failure: no impact on endothelial function and cardiovascular parameters despite normalization of androgen status. | |
| | |
MedLine Citation:
|
PMID: 17302879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Female adrenal insufficiency implicates reduced production of the adrenal androgen precursor dehydroepiandrosterone (DHEA) and low androgen levels. Oral DHEA restores androgen deficit but the clinical implications and safety of substitution therapy is uncertain. A putative DHEA receptor in vascular endothelium has been described and in vitro studies have shown involvement of DHEA in NO dependent pathways. AIM: To evaluate effects of DHEA substitution on cardiovascular parameters. DESIGN: Six months randomized, double-blind, placebo-controlled crossover study. Treatment consisted of DHEA 50-mg or placebo. Each treatment period was followed by a 2-month washout period. MATERIAL AND METHODS: Ten females with documented adrenal failure were included. Androgen levels were measured. Cardiovascular evaluation was performed before and after every treatment period. Two patients left the study because of skin side effects and anxiety, respectively. All patients had low circulating androgens baseline and normal range androgens during DHEA treatment. We examined patients with noninvasive endothelial cell function, magnetic resonance imaging (MRI)-based cardiac output, echocardiography, ambulatory 24-h blood pressure and maximal oxygen consumption. RESULTS: DHEA treatment normalized androgen status to levels seen in healthy women. DHEA and placebo treatment had no effect on echocardiographic parameters of myocardial dimensions or systolic and diastolic function, noninvasive endothelial cell function at the level of the brachial artery, 24-h blood pressure and heart rate, cardiac output and maximal oxygen consumption during exercise cycle testing. Remarkably, all participants had evidence of concentric left ventricular remodelling by echocardiography. CONCLUSION: Restoration of physiological androgen levels using 6 months of DHEA replacement in this pilot study did not affect cardiovascular parameters and endothelial function in female adrenal insufficiency. |
| | |
Authors:
|
Jens Juel Christiansen; Niels Holmark Andersen; Keld E Sørensen; Erik Morre Pedersen; Paul Bennett; Marianne Andersen; Jens Sandahl Christiansen; Jens Otto Lunde Jørgensen; Claus Højbjerg Gravholt |
Related Documents
:
|
14604739 - Long-term safety and efficacy of the selective aldosterone blocker eplerenone in patien... 18195199 - Cardiovascular outcomes in patients with primary aldosteronism after treatment. 2446069 - Antihypertensive mode of action of ketanserin. 11541179 - Effects of the renin-angiotensin-aldosterone system on the cardiovascular system during... 17173239 - The kidney and hypertension: over 70 years of research. 3890539 - Aldosterone studies in obese patients with hypertension. 18779989 - Correlation of echocardiographic markers and therapy in persistent pulmonary hypertensi... 21983009 - Carotid and brachial arterial enlargement in postmenopausal women with hypertension. 9449439 - Direct measurement of intra-abdominal pressure in various conditions. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Clinical endocrinology Volume: 66 ISSN: 0300-0664 ISO Abbreviation: Clin. Endocrinol. (Oxf) Publication Date: 2007 Mar |
Date Detail:
|
Created Date: 2007-02-16 Completed Date: 2007-08-20 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0346653 Medline TA: Clin Endocrinol (Oxf) Country: England |
Other Details:
|
Languages: eng Pagination: 426-33 Citation Subset: IM |
Affiliation:
|
Medical Department M, Aarhus Sygehus, Aarhus University Hospital, Denmark. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adrenal Insufficiency
/
blood,
drug therapy*,
ultrasonography Adult Androgens / blood* Cardiac Output Cross-Over Studies Dehydroepiandrosterone / therapeutic use* Dehydroepiandrosterone Sulfate / blood Dihydrotestosterone / blood Double-Blind Method Echocardiography Estradiol / blood Female Hormone Replacement Therapy* Humans Magnetic Resonance Imaging Middle Aged Statistics, Nonparametric Testosterone / blood |
| Chemical | |
Reg. No./Substance:
|
0/Androgens; 50-28-2/Estradiol; 521-18-6/Dihydrotestosterone; 53-43-0/Dehydroepiandrosterone; 58-22-0/Testosterone; 651-48-9/Dehydroepiandrosterone Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Increased carotid intima-media thickness in remote and urban Indigenous Australians: impact of diabe...
Next Document: Differential regulation of visfatin and adiponectin in pregnancies with normal and abnormal placenta...