Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism.
OBJECTIVE
In female adrenal insufficiency, dehydroepiandrosterone (DHEA) secretion is impaired and circulating androgen levels are severely reduced. We wanted to analyse the acute effects of physiological DHEA substitution on substrate metabolism.


METHODS
We studied nine females with adrenal insufficiency after 9 days of oral DHEA replacement (50 mg/day) in a double-blind, placebo-controlled crossover study.


METHODS
Whole body and regional substrate metabolism was assayed in the basal state and during a euglycemic hyperinsulinemic glucose clamp by means of isotope dilution techniques (glucose, phenylalanine, tyrosine), indirect calorimetry and in situ lipolysis (microdialysis technique).


RESULTS
DHEA treatment normalized the levels of all androgens. Basal and insulin-stimulated total energy expenditure and rates of protein, lipid and glucose oxidation were unaffected by DHEA. Whole body turnover of glucose and protein were also unaffected by DHEA. Forearm breakdown of protein was reduced by insulin to the same extent after placebo and DHEA. Insulin sensitivity as expressed by the glucose infusion rate during the euglycemic clamp was similar after placebo and DHEA. Finally, the interstitial release of glycerol in adipose tissue was not significantly influenced by DHEA.


CONCLUSIONS
Short-term oral DHEA replacement in women with adrenal insufficiency was not associated with measurable changes in total or regional substrate metabolism.
Christiansen
Jens Juel
JJ
Medical Department M, Arhus Sygehus, Arhus University Hospital, Arhus, Denmark.
Gravholt
Claus Højbjerg
CH
Fisker
Sanne
S
Møller
Niels
N
Andersen
Marianne
M
Svenstrup
Birgit
B
Bennett
Paul
P
Ivarsen
Per
P
Christiansen
Jens Sandahl
JS
Jørgensen
Jens Otto Lunde
JO
D000309:Adrenal Insufficiency / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D000328:Adult; D000735:Androstenedione / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D050356:Lipid Metabolism; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000031:analogs & derivatives* / Q000097:blood; D013963:Thyroid Hormones / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1; D011506:Proteins; D012738:Sex Hormone-Binding Globulin; D013963:Thyroid Hormones; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; C013915:boldenone; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone