Fatty acid metabolism in the elderly: effects of dehydroepiandrosterone and testosterone replacement in hormonally deficient men and women.
BACKGROUND
Aging, low dehydroepiandrosterone (DHEA), and testosterone are associated with increased adiposity and metabolic risk. Treatment with these hormones may improve these abnormalities.


OBJECTIVE
The objective of the study was to determine effects of aging, DHEA, or testosterone replacement on adiposity, meal fat partitioning, and postabsorptive lipolysis.


METHODS
This was a cross-sectional, 2-yr, double-blind, randomized, placebo-controlled trial.


METHODS
The study was conducted in the general community.


METHODS
Elderly women and men (>or=60 yr) with low DHEA sulfate (women and men) and bioavailable testosterone (men) concentrations and young adults.


METHODS
Thirty elderly women each received 50 mg DHEA or placebo daily for 2 yr. Thirty elderly men received 75 mg DHEA, 29 received 5 mg testosterone (patch), and 32 received placebo daily for 2 yr. Thirty young women and 32 young men served as controls.


METHODS
In vivo measures of meal fat storage into sc fat, postabsorptive lipolysis, and regional adiposity at baseline and after treatment.


RESULTS
At baseline, the elderly had more body fat, greater systemic lipolysis (women, P = 0.0003; men, P < 0.0001) adjusted for resting energy expenditure, greater meal fat oxidation (women, P = 0.026; men, P = 0.0025), and less meal fat storage in sc fat (women, P = 0.0139; men, P= 0.0006). Although testosterone treatment increased meal fat storage into upper- vs. lower-body fat in elderly men, neither hormone affected regional adiposity, meal fat oxidation, or systemic lipolysis.


CONCLUSIONS
Aging, in the context of low DHEA sulfate (women and men) and bioavailable testosterone (men) concentrations, is associated with changes in meal fat partitioning and postabsorptive lipolysis that are not corrected by DHEA and only partly corrected by testosterone replacement.
Koutsari
Christina
C
Endocrine Research, Mayo Clinic, Rochester, Minnesota 55905, USA.
Ali
Asem H
AH
Nair
K Sreekumaran
KS
Rizza
Robert A
RA
O'Brien
Peter
P
Khosla
Sundeep
S
Jensen
Michael D
MD
D000328:Adult; D000368:Aged; D001823:Body Composition; D050218:Body Fat Distribution; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004734:Energy Metabolism; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008066:Lipolysis; D008297:Male; D008875:Middle Aged; D013739:Testosterone / Q000627:therapeutic use*
D005227:Fatty Acids; D013739:Testosterone; D003687:Dehydroepiandrosterone