Document Detail


Long-term DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial.
MedLine Citation:
PMID:  18000094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are the major circulating adrenal steroids and substrates for peripheral sex hormone biosynthesis. In Addison's disease, glucocorticoid and mineralocorticoid deficiencies require lifelong replacement, but the associated near-total failure of DHEA synthesis is not typically corrected.
OBJECTIVE AND DESIGN: In a double-blind trial, we randomized 106 subjects (44 males, 62 females) with Addison's disease to receive either 50 mg daily of micronized DHEA or placebo orally for 12 months to evaluate its longer-term effects on bone mineral density, body composition, and cognitive function together with well-being and fatigue.
RESULTS: Circulating DHEAS and androstenedione rose significantly in both sexes, with testosterone increasing to low normal levels only in females. DHEA reversed ongoing loss of bone mineral density at the femoral neck (P < 0.05) but not at other sites; DHEA enhanced total body (P = 0.02) and truncal (P = 0.017) lean mass significantly with no change in fat mass. At baseline, subscales of psychological well-being in questionnaires (Short Form-36, General Health Questionnaire-30), were significantly worse in Addison's patients vs. control populations (P < 0.001), and one subscale of SF-36 improved significantly (P = 0.004) after DHEA treatment. There was no significant benefit of DHEA treatment on fatigue or cognitive or sexual function. Supraphysiological DHEAS levels were achieved in some older females who experienced mild androgenic side effects.
CONCLUSION: Although further long-term studies of DHEA therapy, with dosage adjustment, are desirable, our results support some beneficial effects of prolonged DHEA treatment in Addison's disease.
Authors:
Eleanor M Gurnell; Penelope J Hunt; Suzanne E Curran; Catherine L Conway; Eleanor M Pullenayegum; Felicia A Huppert; Juliet E Compston; Joseph Herbert; V Krishna K Chatterjee
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2007-11-13
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  93     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-08     Completed Date:  2008-04-10     Revised Date:  2013-03-27    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  400-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Addison Disease / blood,  drug therapy*
Adult
Aged
Body Composition / drug effects
Bone Density / drug effects
Cognition / drug effects
Dehydroepiandrosterone / therapeutic use*
Dehydroepiandrosterone Sulfate / blood
Double-Blind Method
Female
Hormone Replacement Therapy / methods*
Humans
Male
Middle Aged
Prospective Studies
Quality of Life
Questionnaires
Statistics, Nonparametric
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Chemical
Reg. No./Substance:
53-43-0/Dehydroepiandrosterone; 651-48-9/Dehydroepiandrosterone Sulfate
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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