HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 89/5/1459    most recent ajcn.2008.27265v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Weiss, E. P Articles by Villareal, D. T Search for Related Content PubMed PubMed Citation Articles by Weiss, E. P Articles by Villareal, D. T Agricola Articles by Weiss, E. P Articles by Villareal, D. T

Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone^1,2,3

¹ From the Division of Geriatrics and Nutritional Sciences, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO (EPW, KS, LF, CPL, JOH, and DTV); the Department of Nutrition and Dietetics, Saint Louis University, St Louis, MO (EPW); and the Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanitá, Rome, Italy (LF).

² Supported by NIH research grant AG020076, NIH General Clinical Research Center grant RR00036, and NIH Clinical Nutrition Research Unit grant DK56341. EPW was supported by NIH grant AG00078.

³ Reprints not available. Address correspondence to EP Weiss, 3437 Caroline Street, Room 3076, St Louis, MO. E-mail: eweiss4{at}slu.edu.

ABSTRACT

Background: Age-related reductions in serum dehydroepiandrosterone (DHEA) concentrations may be involved in bone mineral density (BMD) losses.

Objective: The objective was to determine whether DHEA supplementation in older adults improves BMD when co-administered with vitamin D and calcium.

Design: In year 1, a randomized trial was conducted in which men (n = 55) and women (n = 58) aged 65–75 y took 50 mg/d oral DHEA supplements or placebo. In year 2, all participants took open-label DHEA (50 mg/d). During both years, all participants received vitamin D (16 µg/d) and calcium (700 mg/d) supplements. BMD was measured by using dual-energy X-ray absorptiometry. Concentrations of hormones and bone turnover markers were measured in serum.

Results: In men, no difference between groups occurred in any BMD measures or in bone turnover markers during year 1 or year 2. The free testosterone index and estradiol increased in the DHEA group only. In women, spine BMD increased by 1.7 ± 0.6% (P = 0.0003) during year 1 and by 3.6 ± 0.7% after 2 y of supplementation in the DHEA group; however, in the placebo group, spine BMD was unchanged during year 1 but increased to 2.6 ± 0.9% above baseline during year 2 after the crossover to DHEA. Hip BMD did not change. Testosterone, estradiol, and insulin-like growth factor 1 increased in the DHEA group only. In both groups, serum concentrations of bone turnover markers decreased during year 1 and remained low during year 2, but did not differ between groups.

Conclusion: DHEA supplementation in older women, but not in men, improves spine BMD when co-administered with vitamin D and calcium. This trial was registered at clinicaltrials.gov as NCT00182975.

Received for publication November 21, 2008. Accepted for publication February 15, 2009.