Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial.
BACKGROUND
Dehydroepiandrosterone (DHEA) administration has been shown to reduce accumulation of abdominal visceral fat and protect against insulin resistance in laboratory animals, but it is not known whether DHEA decreases abdominal obesity in humans. DHEA is widely available as a dietary supplement without a prescription.


OBJECTIVE
To determine whether DHEA replacement therapy decreases abdominal fat and improves insulin action in elderly persons.


METHODS
Randomized, double-blind, placebo-controlled trial conducted in a US university-based research center from June 2001 to February 2004.


METHODS
Fifty-six elderly persons (28 women and 28 men aged 71 [range, 65-78] years) with age-related decrease in DHEA level.


METHODS
Participants were randomly assigned to receive 50 mg/d of DHEA or matching placebo for 6 months.


METHODS
The primary outcome measures were 6-month change in visceral and subcutaneous abdominal fat measured by magnetic resonance imaging and glucose and insulin responses to an oral glucose tolerance test (OGTT).


RESULTS
Of the 56 men and women enrolled, 52 underwent follow-up evaluations. Compliance with the intervention was 97% in the DHEA group and 95% in the placebo group. Based on intention-to-treat analyses, DHEA therapy compared with placebo induced significant decreases in visceral fat area (-13 cm2 vs +3 cm2, respectively; P = .001) and subcutaneous fat (-13 cm2 vs +2 cm2, P = .003). The insulin area under the curve (AUC) during the OGTT was significantly reduced after 6 months of DHEA therapy compared with placebo (-1119 muU/mL per 2 hours vs +818 muU/mL per 2 hours, P = .007). Despite the lower insulin levels, the glucose AUC was unchanged, resulting in a significant increase in an insulin sensitivity index in response to DHEA compared with placebo (+1.4 vs -0.7, P = .005).


CONCLUSIONS
DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity.
Villareal
Dennis T
DT
Division of Geriatrics and Nutritional Science, Department of Medicine, Washington University School of Medicine, St Louis, Mo 63110, USA.
Holloszy
John O
JO
D000005:Abdomen; D000273:Adipose Tissue / Q000187:drug effects*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003687:Dehydroepiandrosterone / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005951:Glucose Tolerance Test; D020249:Hormone Replacement Therapy; D006728:Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control; D009765:Obesity / Q000188:drug therapy
D001786:Blood Glucose; D006728:Hormones; D007328:Insulin; D003687:Dehydroepiandrosterone; D007334:Insulin-Like Growth Factor I