REPLACEMENT OF DEHYDROEPIANDROSTERONE ENHANCES T-LYMPHOCYTE INSULIN BINDING IN POSTMENOPAUSAL WOMEN

Objective: To demonstrate bioavailability of 3 weeks of oral micronize d DHEA and to delineate changes induced on insulin sensitivity, morpho metric indexes, and lipoprotein profiles. Design: Oral micronized DHEA (50 mg/d) was administered in 3-week treatments to 11 postmenopausal women in a prospective, placebo-controlled, randomized, blinded, cross over trial with an interarm washout. After dose (23 hour) serum DHEA, DHEAS, T, and cortisol levels were measured, as were fasting lipoprote ins, oral glucose tolerance tests (OGTT), T-lymphocyte insulin binding and degradation, and urine collagen cross-links. Morphometric changes were determined by hydrostatic weighing. Results: Dehydroepiandroster one sulfate, DHEA, T, and free T increased up to two times premenopaus al levels with treatment. Fasting triglycerides declined; no change in collagen cross-links or morphometric indexes was noted. Oral glucose tolerance test parameters did not change, but both T-lymphocyte insuli n binding and degradation increased with DHEA. Conclusion: Fifty milli grams per day of oral DHEA gives supraphysiologic androgen levels; 25 mg/d may be more appropriate. Dehydroepiandrosterone enhanced tissue i nsulin sensitivity and lowered serum triglycerides. Rationale is provi ded for postmenopausal replacement therapy with this androgen.