Metabolic effects of dehydroepiandrosterone replacement therapy in postmenopausal women

Objective: To investigate whether long-term treatment with dehydroepiandros terone (DI-IEA) in postmenopausal women can modify insulin sensitivity and plasma lipid profile. Design and methods: Twenty healthy postmenopausal women with serum dehydroe piandrosterone sulfate (DHEA-S) concentrations <2.5 <mu>mol/l were enrolled and randomly assigned to two different treatment groups: group 1 were trea ted with micronized DHEA, 25 mg/day at 0800 h for 12 months; group 2 were t reated with an identical placebo tablet. At the beginning and at the end of the study, plasma lipid profile, glucose tolerance (oral glucose tolerance test) and insulin sensitivity (euglycemic hyperinsulinemic clamp: M index) were assessed. Results: After 12 months, the group treated with DHEA showed a considerable improvement of insulin sensitivity (M index +29.55%, P=0.01) and lipid pat tern (high-density lipoprotein cholesterol +11.61%. P=0.03; low-density lip oprotein cholesterol -11.07%, P=0.04; triglycerides -19.60%, P=0.03), but g lucose tolerance did not change. No modifications were observed in the plac ebo group. Conclusions: Long-term treatment with DHEA ameliorates some metabolic param eters that are linked to increased cardiovascular risk and. consequently, t his seems to be an interesting therapeutic tool in the management of the po stmenopausal syndrome.