Effect of dehydroepiandrosterone replacement on lipoprotein profile in hypoadrenal women.
BACKGROUND
Levels of dehydroepiandrosterone (DHEA) and its sulfate form (DHEAS) are inversely associated with cardiovascular mortality in men but not women. Very little evidence is available on the impact of DHEA administration on lipoprotein profile in women. DHEAS levels are very low/undetectable in hypoadrenal women.


OBJECTIVE
The objective of the study was to determine the impact of DHEA replacement on lipoprotein profile in hypoadrenal women.


METHODS
A double-blind, randomized, placebo-controlled, cross-over design study was conducted at the Mayo Clinic.


METHODS
Thirty-three hypoadrenal Caucasian women (mean +/- sd; age 50.3 +/- 15.2 yr, body mass index 26.6 +/- 4.4 kg/m(2)) took part in the study.


METHODS
Study participants were assigned to receive either a placebo or 50 mg/d of DHEA for 3 months each. Lipid levels and lipoprotein profile were analyzed using the Lipo Science Lipoprotein nuclear magnetic resonance system.


METHODS
Changes in various lipoprotein sizes and levels were measured.


RESULTS
The DHEA period had higher plasma DHEAS levels than during placebo (<0.3 +/- 0.0 vs. 3.5 +/- 1.3 nmol/liter, P < 0.001). DHEA replacement significantly reduced total cholesterol (20.0 vs. -22, P = 0.02) and high-density lipoprotein (HDL) levels (2.0 vs. -6.0, P = 0.006) and tends to reduce triglyceride and total low-density lipoprotein levels. Although, DHEA replacement had no effect on low-density lipoprotein particle size, it significantly reduced larger HDL particles and to modest extent small HDL particles.


CONCLUSIONS
Our study findings showed that oral DHEA administration in hypoadrenal women results in an unfavorable lipoprotein profile. The results warrant long-term studies to determine the impact of DHEA replacement on cardiovascular risk.
Srinivasan
Manivannan
M
Division of Endocrinology, Endocrine Research Unit, Mayo Clinic and Mayo Foundation,, Rochester, Minnesota 55905, USA.
Irving
Brian A
BA
Dhatariya
Ketan
K
Klaus
Katherine A
KA
Hartman
Stacy J
SJ
McConnell
Joseph P
JP
Nair
K Sreekumaran
KS
D000309:Adrenal Insufficiency / Q000097:blood / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology; D018592:Cross-Over Studies; D003687:Dehydroepiandrosterone / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008875:Middle Aged
D008076:Cholesterol, HDL; D008074:Lipoproteins; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D003687:Dehydroepiandrosterone