DEHYDROEPIANDROSTERONE-SULFATE AND BONE-MINERAL DENSITY

Several series of data suggest that alterations in adrenal androgen ou tput might be a contributing factor to changes in bone mass. To study the possible relationship between bone density and serum levels of deh ydroepiandrosterone sulphate (DHEAS) we investigated 105 women (aged 4 5-69 years; 76 postmenopausal, 29 perimenopausal). The patients were d ivided into two groups according to the bone mineral density (BMD) mea surement (normal density n = 50, low density n = 55). BMD was measured by dual-energy X-ray absorptiometry of the lumbar spine and femoral n eck. Bone mineral content (BMC) of the radius midshaft was measured by single photon absorptiometry. Serum DHEAS level was significantly low er in the 'low density' group than in the 'normal' one (1.91 +/- 1.04 v 4.77 +/- 2.03 mumol/1, p < 0.001). The serum DHEAS level decreased s ignificantly with age in both groups (r = 0.43, p < 0.001 in the 'norm al' group; r = 0.35, p < 0.01 in the 'low density' group). Unlike the slopes, the positions of the regression lines differed significantly ( difference 2.85 mumol/1, p < 0.001). Correcting for age by multiple li near regression we established a significant positive relationship bet ween DHEAS and BMD of the lumbar spine and femoral neck, and BMC of ra dius midshaft as well. Since there was no significant difference betwe en the two groups regarding oestrogens, we suggest that DHEAS may have a non-oestrogenic effect on bone. The odds ratio of a subject with a low (< 3.3 mumol/1) serum DHEAS level having low BMD was 40 (confidenc e interval 13-126). We conclude that serum DHEAS may be a useful indic ator of low BMD in peri- and postmenopausal women.