Metabolic and hormonal effects of oral DHEA in premenopausal women with HIV infection: a randomized, prospective, placebo-controlled pilot study.
Metabolic and hormonal effects of oral DHEA in premenopausal women with HIV infection: a randomized, prospective, placebo-controlled pilot study.
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DOI：
10.1055/s-0028-1087175
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Rabkin J
中科院分区：
文献类型：
--
作者：
Poretsky L;Song L;Brillon DJ;Ferrando S;Chiu J;McElhiney M;Ferenczi A;Sison C;Haller I;Rabkin J
Patients with HIV infection, both men and women, sometimes use dehydroepiandrosterone (DHEA) because of its reputation as a “youth hormone” which can improve mood and energy level. DHEA can be obtained without a prescription. However, endocrine effects of DHEA in HIV- infected individuals are poorly understood. We recently reported the endocrine effects of DHEA in HIV-infected men. We now present the results of a randomized placebo controlled double-blind study of endocrine effects of DHEA in HIV-infected women. our aim was to explore the effects of DHEA on the hypothalamic-pituitary-adrenal (HPA) axis, sex steroids, circulating insulin, adiponectin, IGF-I, IGFBP-1 and IGFBP-3 in HIV infected premenopausal females. We conducted an 8-week randomized placebo controlled pilot trial of DHEA in HIV positive men and women with non-major depression. Increasing doses (100–400mg/day) of oral DHEA were administered. One hundred forty-five patients (122 men and 23 women) were randomized to receive either DHEA or placebo. 133 patients, including all 23 women, completed the trial. Of these women, 15 agreed to participate in the endocrine sub-study, conducted at the Weill Cornell GCRC. Of these, nine women were randomized to receive oral DHEA and six to placebo. Low (1mcg) dose ACTH, CRF and GnRH stimulation tests were performed in each subject before and after 8 weeks of treatment with DHEA or placebo. DHEA, DHT, 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 before and after 8 weeks of treatment with DHEA or placebo. Wilcoxon Signed Rank and the Mann Whitney tests were used to analyze the data. There was a significant increase in mean DHEA-S concentration (ELISA assay) (from 95+/−88 ng/ml before the study to 1138+/−849 ng/ml at week 8 of treatment, p<0.008) in the DHEA group, but not in the placebo group. There was a significant increase in the mean total testosterone concentration (0.21+/−0.1 vs. 0.76+/−0.6 ng/ml, p<0.008) and dihydrotestosterone (DHT) concentration (142.9+/−67 vs. 907.2+/−523 ng/ml, p<0.004) in the DHEA group but not in the placebo group. In addition, there was a significant increase in the estrone concentration in the DHEA group (144.3+/−83 vs 309.6+/−142 pg/ml, p<0.03) but not in the placebo group. There was a significant increase in the mean plasma concentrations of DHEA-S (p<0.032), DHEA (p<0.0006), total testosterone (p<0.01) and dihydrotestosterone (p<0.005) in the DHEA group when compared to the placebo group. There was no change in the cortisol concentration, fasting serum insulin, sex hormone binding globulin, free testosterone, estradiol, adiponectin, IGF-1, IGFBP-1 or IGFBP-3 concentrations, or ACTH, CRF or GnRH test results from week 1 to week 8 in either the DHEA or placebo groups. We conclude that oral DHEA administration results in a significant increase in circulating DHEA-S, testosterone, DHT and, possibly, estrone levels in premenopausal women with HIV infection. These changes are not accompanied by significant changes in the overall function of pituitary or adrenal axes or in insulin/IGF indices. Long-term studies with larger numbers of patients are needed to confirm these data and to determine their clinical significance.
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影响因子：
3.2
作者：
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通讯作者：
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影响因子：
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