Metabolic and hormonal effects of oral DHEA in premenopausal women with HIV infection: a randomized, prospective, placebo-controlled pilot study.
Women with HIV infection use dehydroepiandrosterone (DHEA) because of its potential effects on mood and energy. We examined the effects of DHEA on the hypothalamic-pituitary-adrenal and gonadal axes and on insulin sensitivity. Fifteen HIV-positive women were randomized to receive placebo (6 subjects) or oral DHEA (9 subjects). ACTH-, CRF-, and GnRH-stimulation tests were performed before and after 8 weeks of treatment. DHEA, DHEA-S, dihydrotestosterone, total testosterone, free testosterone, sex hormone-binding globulin, estrone, estradiol, cortisol, insulin, IGF-1, IGFBP-1, IGFBP-3, and adiponectin in plasma or serum were measured. There was a significant increase in DHEA (p<0.004), DHEA-S (p<0.008), total testosterone (p<0.008), dihydrotestosterone (p<0.004), androstenedione (p<0.04), and estrone (p<0.03) from baseline within the DHEA group but not within the placebo group. There was a significant increase in DHEA (p<0.0006), DHEA-S (p<0.032), total testosterone (p<0.01), and dihydrotestosterone (p<0.005) in the DHEA group compared with the placebo group. Oral DHEA produces significant increases in circulating DHEA, DHEA-S, testosterone, DHT, and, possibly, androstenedione and estrone levels in premenopausal women with HIV infection. In the current pilot study these hormone changes did not affect the pituitary or adrenal axis or insulin/IGF indices. Long-term studies with larger groups of patients are needed to confirm these data and to determine their clinical significance.
Poretsky
L
L
Division of Endocrinology, Department of Medicine, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, USA. lporetsk@chpnet.org
Song
L
L
Brillon
D J
DJ
Ferrando
S
S
Chiu
J
J
McElhiney
M
M
Ferenczi
A
A
Sison
C
C
Haller
I
I
Rabkin
J
J
D000284:Administration, Oral; D000339:Affect / Q000187:drug effects / Q000502:physiology*; D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D013196:Dihydrotestosterone / Q000097:blood; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000187:drug effects; D004970:Estrone / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D007700:Kinetics; D019964:Mood Disorders / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D010865:Pilot Projects; D010919:Placebos; D017697:Premenopause; D013739:Testosterone / Q000097:blood; D013997:Time Factors
D010919:Placebos; D013196:Dihydrotestosterone; D004970:Estrone; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone