title: Effect of DHEA supplementation on serum IGF-1, osteocalcin, and bone mineral density in postmenopausal, glucocorticoid-treated women.
abstract: OBJECTIVE
  DHEA therapy increases bone formation in postmenopausal women. We have found only a few reports of dehydroepiandrosterone replacement therapy in women receiving long-term glucocorticoid medication. The purpose of this study was to establish whether DHEA replacement therapy may be useful in the treatment of steroid-induced osteoporosis in postmenopausal women.
  
  
  METHODS
  Nineteen women, aged 50-78 years, treated at least for three years with average daily doses of more than 7.5 mg prednisone, with T-score L2/L4<-1.5 and bisphosphonates intolerance, were enrolled to the study. For the first year of the study the patients were given calcium, vitamin D3 and thiazide diuretics. For another year the patients received orally micronized DHEA 25-50 mg daily. Before the study, after twelve months of Calcium/D3 therapy, then after six weeks and six months of DHEA therapy, serum concentrations of DHEAS, androstenedione, testosterone, estradiol, FSH, IGF-1 and osteocalcin were assessed. Bone mineral density (BMD) in lumbar spine and femoral neck was measured before the treatment, after a year on Calcium/D3 and after six and twelve months of DHEA replacement therapy.
  
  
  RESULTS
  In all treated women, DHEA significantly increased serum DHEAS, androstenedione and testosterone concentrations. A significant elevation of serum IGF-1 and osteocalcin concentrations was found as early as after six weeks of DHEA treatment. A significant increase of bone mineral density in the lumbar spine and femoral neck was observed after six and twelve months of DHEA treatment.
  
  
  CONCLUSIONS
  Our results suggest a beneficial role of DHEA replacement therapy in the treatment of steroid-induced osteoporosis.
authors.affiliation: Department of Endocrinology, Medical Centre for Postgraduate Education, Warsaw, Poland. klinendo@cmkp.edu.pl
authors.forename: L
authors.initials: L
authors.lastname: Papierska
authors.forename: M
authors.initials: M
authors.lastname: Rabijewski
authors.forename: A
authors.initials: A
authors.lastname: Kasperlik-Załuska
authors.forename: W
authors.initials: W
authors.lastname: Zgliczyński
mesh_terms: D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D010024:Osteoporosis / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids; D015675:Osteocalcin; D003687:Dehydroepiandrosterone; D007334:Insulin-Like Growth Factor I