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Randomized Controlled Trial
. 2009 May;89(5):1459-67.
doi: 10.3945/ajcn.2008.27265. Epub 2009 Mar 25.

Dehydroepiandrosterone Replacement Therapy in Older Adults: 1- And 2-y Effects on Bone

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Free PMC article
Randomized Controlled Trial

Dehydroepiandrosterone Replacement Therapy in Older Adults: 1- And 2-y Effects on Bone

Edward P Weiss et al. Am J Clin Nutr. .
Free PMC article

Abstract

Background: Age-related reductions in serum dehydroepiandrosterone (DHEA) concentrations may be involved in bone mineral density (BMD) losses.

Objective: The objective was to determine whether DHEA supplementation in older adults improves BMD when co-administered with vitamin D and calcium.

Design: In year 1, a randomized trial was conducted in which men (n = 55) and women (n = 58) aged 65-75 y took 50 mg/d oral DHEA supplements or placebo. In year 2, all participants took open-label DHEA (50 mg/d). During both years, all participants received vitamin D (16 microg/d) and calcium (700 mg/d) supplements. BMD was measured by using dual-energy X-ray absorptiometry. Concentrations of hormones and bone turnover markers were measured in serum.

Results: In men, no difference between groups occurred in any BMD measures or in bone turnover markers during year 1 or year 2. The free testosterone index and estradiol increased in the DHEA group only. In women, spine BMD increased by 1.7 +/- 0.6% (P = 0.0003) during year 1 and by 3.6 +/- 0.7% after 2 y of supplementation in the DHEA group; however, in the placebo group, spine BMD was unchanged during year 1 but increased to 2.6 +/- 0.9% above baseline during year 2 after the crossover to DHEA. Hip BMD did not change. Testosterone, estradiol, and insulin-like growth factor 1 increased in the DHEA group only. In both groups, serum concentrations of bone turnover markers decreased during year 1 and remained low during year 2, but did not differ between groups.

Conclusion: DHEA supplementation in older women, but not in men, improves spine BMD when co-administered with vitamin D and calcium. This trial was registered at clinicaltrials.gov as NCT00182975.

Figures

FIGURE 1
FIGURE 1
Consort diagram indicating sample sizes at each stage during the study. DHEA, dehydroepiandrosterone.
FIGURE 2
FIGURE 2
Arithmetic mean (±SE) changes in serum concentrations of dehydroepiandrosterone sulfate (DHEAS) during the 1-y randomized placebo-controlled trial (top: n = 55 men and 58 women) and during the 2-y extension study (bottom: n = 45 men and 45 women). During the 2-y extension study, participants took dehydroepiandrosterone (DHEA) supplements for 2 y (DHEA group) or placebo for 1 y and then DHEA supplements for the next year (crossover group). *P < 0.0001 compared with baseline (within group) and P ≤ 0.0001 for the comparison between the placebo or crossover group at the same time point by 2-factor repeated-measures ANOVA and Tukey-adjusted post hoc paired comparisons (P < 0.0001 for group-by-time interaction in both men and women).
FIGURE 3
FIGURE 3
Arithmetic mean (±SE) percentage changes in lumbar spine bone mineral density (BMD) in response to 2 y of dehydroepiandrosterone (DHEA) replacement therapy (•: n = 21 men and 21 women) or 1 y of placebo followed by 1 y of DHEA replacement therapy (○; n = 24 men and 24 women). *P ≤ 0.05 compared with baseline and P ≤ 0.05 compared with 12 mo (within group and sex) by one-factor repeated-measures ANOVA and Tukey-adjusted post hoc comparisons.

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