Dehydroepiandrosterone (DHEA) replacement reduces growth hormone (GH) dose requirement in female hypopituitary patients on GH replacement

Clin Endocrinol (Oxf). 2006 Nov;65(5):673-80. doi: 10.1111/j.1365-2265.2006.02648.x.

Abstract

Objective: GH dose requirement is lower in ACTH replete compared with ACTH deficient hypopituitary patients suggesting that adrenal androgens may augment IGF-I generation for a given GH dose. This study aimed to determine the effect of dehydroepiandrosterone (DHEA) administration on GH dose requirements in hypopituitary adults.

Design: A double blind placebo controlled trial was conducted adding 50 mg DHEA to the standard replacement of hypopituitary patients, including GH, over an initial 6 months, followed by an open phase study of 6 months DHEA replacement and a final 2 month washout phase after DHEA withdrawal. The dose of GH was adjusted to achieve a constant serum IGF-I.

Patients: Thirty female and 21 male hypopituitary patients were enrolled. Data from 26 women and 18 men were analysed after patient withdrawal.

Measurements: The primary outcome objective was the GH dose required to achieve a stable serum IGF-I. Secondary outcome measures were lipoprotein profiles, insulin, insulin sensitivity, IGFBP-3, waist/hip ratio and indices of bone remodelling.

Results: DHEA replacement in female patients lead to a 14.6 +/- 20% reduction in the dose of GH for a constant serum IGF-I (P < 0.05, 95% CI: 1.8, 32.7). This was maintained for 12 months and there was a significant fall in serum IGF-I two months after withdrawal of DHEA. There was no change in the male group.

Conclusions: DHEA replacement may reduce GH dose requirements in female hypopituitary patients.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Dehydroepiandrosterone / blood
  • Dehydroepiandrosterone / therapeutic use*
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Growth Hormone / blood
  • Hormone Replacement Therapy*
  • Human Growth Hormone / administration & dosage*
  • Human Growth Hormone / therapeutic use
  • Humans
  • Hypopituitarism / blood
  • Hypopituitarism / drug therapy*
  • Insulin-Like Growth Factor Binding Protein 3 / blood
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Time Factors
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Insulin-Like Growth Factor Binding Protein 3
  • Triglycerides
  • Human Growth Hormone
  • Dehydroepiandrosterone
  • Insulin-Like Growth Factor I
  • Growth Hormone
  • Cholesterol