Effects of DHEA replacement on bone mineral density and body composition in elderly women and men

OBJECTIVE Dehydroepiandrosterone (DHEA) is a precursor for both oestrogens and androgens. Its marked decline with ageing may influence age-related cha nges in tissues influenced by sex hormones. The aim of this study was to de termine the effects of DHEA replacement on bone mineral density (BMD) and b ody composition in elderly women and men with low serum DHEA sulphate (DHEA S) levels. DESIGN Prospective 6 month trial of oral DHEA replacement, 50 mg/day. PATIENTS Experimental subjects were 10 women and eight men, aged 73 +/- 1 y ears. Control subjects were 10 women and eight men, aged 74 +/- 1 years. MEASUREMENTS BMD, body composition, serum markers of bone turnover, serum l ipids and lipoproteins, oral glucose tolerance, serum IGF-I, total serum oe strogens and testosterone. RESULTS BMD of the total body and lumbar spine increased (mean +/- SEM; 1.6 +/- 0.6% and 2.5 +/- 0.8%, respectively; both P less than or equal to 0.05 ), fat mass decreased (- 1.3 +/- 0.4 kg; P < 0.01) and fat-free mass increa sed (0.9 +/- 0.4 kg; P less than or equal to 0.05) in response to DHEA repl acement. DHEA replacement also resulted in increases in serum IGF-I (from 1 08 +/- 8 to 143 +/- 7 mug/l; P < 0.01) and total serum testosterone concent rations (from 10.7 +/- 1.2 to 15.6 +/- 1.8 nmol/l in the men and from 2.1 /- 0.2 to 4.5 +/- 0.4 nmol/l in the women; both P less than or equal to 0.0 5). CONCLUSIONS The results provide preliminary evidence that DHEA replacement in those elderly women and men who have very low serum DHEAS levels can par tially reverse age-related changes in fat mass, fat-free mass, and BMD, and raise the possibility that increases in IGF-I and/or testosterone play a r ole in mediating these effects of DHEA.