Endocrine effects of oral dehydroepiandrosterone in men with HIV infection: a prospective, randomized, double-blind, placebo-controlled trial.
Dehydroepiandrosterone (DHEA) is commonly used by HIV-infected men, but its endocrine effects in this population are not well defined. We conducted an 8-week randomized, placebo-controlled trial to determine the effects of escalating doses (100-400 mg/d) of DHEA on the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, and on a number of metabolic parameters in 69 HIV-positive men (31 in DHEA-treated group, 38 in placebo group). High-dose (250 microg) corticotropin and luteinizing hormone-releasing hormone stimulation tests were carried out in all subjects. Fifty-four subjects (26 in the DHEA-treated group and 28 in the placebo group) also underwent optional corticotropin-releasing hormone test, and 67 subjects (31 in DHEA-treated group and 36 in placebo group) underwent optional low-dose (1 microg) corticotropin stimulation test. All tests were performed at baseline and at the end of week 8. Repeated-measures analysis of variance was used to analyze the data. We observed significant increases in circulating levels of DHEA, DHEA-sulfate, free testosterone, dihydrotestosterone, androstenedione, and estrone, and a decline in the serum concentration of sex hormone-binding globulin in the DHEA-treated group but not in the placebo group (P < .001). There were no differences between the groups in other endocrine or metabolic parameters or in the results of the stimulation tests. In conclusion, oral DHEA therapy in HIV-positive men significantly increases circulating levels of DHEA and DHEA-sulfate, free testosterone, dihydrotestosterone, androstenedione, and estrone and suppresses circulating concentration of sex hormone-binding globulin. Long-term studies are needed to assess the clinical significance of these hormonal changes in subjects with HIV infection receiving oral DHEA therapy.
Poretsky
Leonid
L
Division of Endocrinology, Department of Medicine, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, NY 10021, USA. lporetsk@bethisraelny.org
Brillon
David J
DJ
Ferrando
Stephen
S
Chiu
Judy
J
McElhiney
Martin
M
Ferenczi
Andrea
A
Sison
Maria Cristina Irene P
MC
Haller
Ivan
I
Rabkin
Judith
J
D000284:Administration, Oral; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000494:pharmacology; D003687:Dehydroepiandrosterone / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D012739:Gonadal Steroid Hormones / Q000097:blood; D015658:HIV Infections / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D003687:Dehydroepiandrosterone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone