Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: A randomized, controlled trial
Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: A randomized, controlled trial
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DOI：
10.1210/jc.2005-2484
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发表时间：
2006-08-01
影响因子：
5.8
通讯作者：
Kohrt, Wendy M.
中科院分区：
文献类型：
--
作者：
Jankowski, Catherine M.;Gozansky, Wendolyn S.;Kohrt, Wendy M.
内容：脱氢表雄酮（DHEA）及其硫酸盐（DHEAS）随着年龄的增长而减少，是老年人重要的雄激素和雌激素前体。DHEAS随着年龄的增长下降可能有助于生理变化，是性激素dependent.Objective：目的是确定是否DHEA替代增加骨矿物质密度（BMD）和无脂mass.Design，设置，和参与者：一个随机，双盲，对照试验进行了学术研究机构。参与者为70名女性和70名男性，年龄在60-88岁之间，血清DHEAS水平较低。干预：干预是口服DHEA 50 mg/d或安慰剂12个月。测量：干预前后测量BMD、脂肪量和去脂肪量。意向治疗分析显示DHEA增加全髋关节BMD的趋势大于安慰剂（1.0%，P = 0.05），转子（1.2%，P = 0.06）和干（1.2%，P = 0.05）。仅在女性中，DHEA增加腰椎BMD（2.2%，P = 0.04;性别-治疗相互作用，P = 0.05）。在二次顺应性分析中，DHEA组髋部BMD增加显著（1.2-1.6%;所有P < 0.02）。有没有显着的效果DHEA对脂肪或无脂肪的质量在意向治疗或遵守analysis.Conclusions：DHEA替代治疗1年改善髋关节骨密度在老年人和脊柱骨密度在老年妇女。由于DHEA治疗效果的随机对照试验很少，这些发现支持进一步研究DHEA替代的益处和风险及其作用机制的必要性。
Context: Dehydroepiandrosterone ( DHEA) and its sulfate (DHEAS) decrease with aging and are important androgen and estrogen precursors in older adults. Declines in DHEAS with aging may contribute to physiological changes that are sex hormone dependent.Objective: The aim was to determine whether DHEA replacement increases bone mineral density (BMD) and fat-free mass.Design, Setting, and Participants: A randomized, double-blinded, controlled trial was conducted at an academic research institution. Participants were 70 women and 70 men, aged 60-88 yr, with low serum DHEAS levels.Intervention: The intervention was oral DHEA 50 mg/d or placebo for 12 months.Measurements: BMD, fat mass, and fat-free mass were measured before and after intervention.Results: Intent-to-treat analyses revealed trends for DHEA to increase BMD more than placebo at the total hip (1.0%, P = 0.05), trochanter (1.2%, P = 0.06), and shaft (1.2%, P = 0.05). In women only, DHEA increased lumbar spine BMD (2.2%, P = 0.04; sex-by-treatment interaction, P = 0.05). In secondary compliance analyses, BMD increases in hip regions were significant (1.2-1.6%; all P < 0.02) in the DHEA group. There were no significant effects of DHEA on fat or fat-free mass in intent-to-treat or compliance analyses.Conclusions: DHEA replacement therapy for 1 yr improved hip BMD in older adults and spine BMD in older women. Because there have been few randomized, controlled trials of the effects of DHEA therapy, these findings support the need for further investigations of the benefits and risks of DHEA replacement and the mechanisms for its actions.