Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: a randomized, controlled trial.
BACKGROUND
Dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) decrease with aging and are important androgen and estrogen precursors in older adults. Declines in DHEAS with aging may contribute to physiological changes that are sex hormone dependent.


OBJECTIVE
The aim was to determine whether DHEA replacement increases bone mineral density (BMD) and fat-free mass.


METHODS
A randomized, double-blinded, controlled trial was conducted at an academic research institution. Participants were 70 women and 70 men, aged 60-88 yr, with low serum DHEAS levels.


METHODS
The intervention was oral DHEA 50 mg/d or placebo for 12 months.


METHODS
BMD, fat mass, and fat-free mass were measured before and after intervention.


RESULTS
Intent-to-treat analyses revealed trends for DHEA to increase BMD more than placebo at the total hip (1.0%, P = 0.05), trochanter (1.2%, P = 0.06), and shaft (1.2%, P = 0.05). In women only, DHEA increased lumbar spine BMD (2.2%, P = 0.04; sex-by-treatment interaction, P = 0.05). In secondary compliance analyses, BMD increases in hip regions were significant (1.2-1.6%; all P < 0.02) in the DHEA group. There were no significant effects of DHEA on fat or fat-free mass in intent-to-treat or compliance analyses.


CONCLUSIONS
DHEA replacement therapy for 1 yr improved hip BMD in older adults and spine BMD in older women. Because there have been few randomized, controlled trials of the effects of DHEA therapy, these findings support the need for further investigations of the benefits and risks of DHEA replacement and the mechanisms for its actions.
Jankowski
Catherine M
CM
Health Sciences Center, University of Colorado at Denver, 4200 East Ninth Avenue, Campus Box B179, Denver, CO 80262, USA.
Gozansky
Wendolyn S
WS
Schwartz
Robert S
RS
Dahl
Daniel J
DJ
Kittelson
John M
JM
Scott
Stephen M
SM
Van Pelt
Rachael E
RE
Kohrt
Wendy M
WM
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage; D003687:Dehydroepiandrosterone / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004032:Diet; D004311:Double-Blind Method; D005260:Female; D005269:Femur; D006615:Hip; D020249:Hormone Replacement Therapy; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012727:Sex Characteristics; D014807:Vitamin D / Q000008:administration & dosage
D002136:Calcium, Dietary; D010919:Placebos; D014807:Vitamin D; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate