Two years of treatment with dehydroepiandrosterone does not improve insulin secretion, insulin action, or postprandial glucose turnover in elderly men or women.
To determine if dehydroepiandrosterone (DHEA) replacement improves insulin secretion, insulin action, and/or postprandial glucose metabolism, 112 elderly subjects with relative DHEA deficiency ingested a labeled mixed meal and underwent a frequently sampled intravenous glucose tolerance test before and after 2 years of either DHEA or placebo. Despite restoring DHEA sulphate concentrations to values observed in young men and women, the changes over time in fasting and postprandial glucose concentrations, meal appearance, glucose disposal, and endogenous glucose production were identical to those observed after 2 years of placebo. The change over time in postmeal and intravenous glucose tolerance test insulin and C-peptide concentrations did not differ in men treated with DHEA or placebo. In contrast, postmeal and intravenous glucose tolerance test change over time in insulin and C-peptide concentrations were greater (P < 0.05) in women after DHEA than after placebo. However, since DHEA tended to decrease insulin action, the change over time in disposition indexes did not differ between DHEA- and placebo-treated women, indicating that the slight increase in insulin secretion was a compensatory response to a slight decrease in insulin action. We conclude that 2 years of replacement of DHEA in elderly men and women does not improve insulin secretion, insulin action, or the pattern of postprandial glucose metabolism.
Basu
Rita
R
Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.
Dalla Man
Chiara
C
Campioni
Marco
M
Basu
Ananda
A
Nair
K Sree
KS
Jensen
Michael D
MD
Khosla
Sundeep
S
Klee
George
G
Toffolo
Gianna
G
Cobelli
Claudio
C
Rizza
Robert A
RA
D000276:Adjuvants, Immunologic / Q000008:administration & dosage* / Q000627:therapeutic use; D000368:Aged; D001823:Body Composition; D002096:C-Peptide / Q000097:blood; D003687:Dehydroepiandrosterone / Q000008:administration & dosage* / Q000627:therapeutic use; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004967:Estrogens / Q000097:blood; D005260:Female; D005769:Gastrointestinal Motility; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008099:Liver / Q000378:metabolism; D008297:Male; D019518:Postprandial Period / Q000502:physiology; D012727:Sex Characteristics; D013739:Testosterone / Q000097:blood; D013997:Time Factors
D000276:Adjuvants, Immunologic; D002096:C-Peptide; D004967:Estrogens; D007328:Insulin; D013739:Testosterone; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D013006:Growth Hormone; D005934:Glucagon; D005947:Glucose; D006854:Hydrocortisone