Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials

Catherine M. Jankowski, Pamela Wolfe, Sarah J. Schmiege, K Sreekumaran Nair, Sundeep Khosla, Michael Dennis Jensen, Denise von Muhlen, Gail A. Laughlin, Donna Kritz-Silverstein, Jaclyn Bergstrom, Richele Bettencourt, Edward P. Weiss, Dennis T. Villareal, Wendy M. Kohrt

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. Design: Pooled analyses of data from four double-blinded, randomized controlled trials. Participants: Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. Measurements: Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). Results: Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0% ± 3.4%) and trochanter (0.5% ± 3.8%) BMD and maintained total hip BMD (0.0% ± 2.8%); men had no BMD benefit and a decrease in fat mass (−0.4 ± 2.6 kg; all P < 0.01 vs placebo). Conclusions: Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.

Original languageEnglish (US)
JournalClinical Endocrinology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Dehydroepiandrosterone
Body Composition
Bone Density
Clinical Trials
Fats
Dehydroepiandrosterone Sulfate
Somatomedins
Estradiol
Placebos
Testosterone
Pelvic Bones
Bone and Bones
Muscles
Gonadal Steroid Hormones
Femur
Tablets
Estrogens
Spine
Therapeutics
Randomized Controlled Trials

Keywords

  • ageing
  • bone density
  • dehydroepiandrosterone
  • fat mass
  • fat-free mass
  • prohormone
  • sex differences

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition : A pooled analysis of four clinical trials. / Jankowski, Catherine M.; Wolfe, Pamela; Schmiege, Sarah J.; Nair, K Sreekumaran; Khosla, Sundeep; Jensen, Michael Dennis; von Muhlen, Denise; Laughlin, Gail A.; Kritz-Silverstein, Donna; Bergstrom, Jaclyn; Bettencourt, Richele; Weiss, Edward P.; Villareal, Dennis T.; Kohrt, Wendy M.

In: Clinical Endocrinology, 01.01.2018.

Research output: Contribution to journalArticle

Jankowski, CM, Wolfe, P, Schmiege, SJ, Nair, KS, Khosla, S, Jensen, MD, von Muhlen, D, Laughlin, GA, Kritz-Silverstein, D, Bergstrom, J, Bettencourt, R, Weiss, EP, Villareal, DT & Kohrt, WM 2018, 'Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials', Clinical Endocrinology. https://doi.org/10.1111/cen.13901
Jankowski, Catherine M. ; Wolfe, Pamela ; Schmiege, Sarah J. ; Nair, K Sreekumaran ; Khosla, Sundeep ; Jensen, Michael Dennis ; von Muhlen, Denise ; Laughlin, Gail A. ; Kritz-Silverstein, Donna ; Bergstrom, Jaclyn ; Bettencourt, Richele ; Weiss, Edward P. ; Villareal, Dennis T. ; Kohrt, Wendy M. / Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition : A pooled analysis of four clinical trials. In: Clinical Endocrinology. 2018.
@article{63cf911942f746eebc44d81cfc734a4d,
title = "Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials",
abstract = "Objective: Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. Design: Pooled analyses of data from four double-blinded, randomized controlled trials. Participants: Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. Measurements: Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). Results: Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0{\%} ± 3.4{\%}) and trochanter (0.5{\%} ± 3.8{\%}) BMD and maintained total hip BMD (0.0{\%} ± 2.8{\%}); men had no BMD benefit and a decrease in fat mass (−0.4 ± 2.6 kg; all P < 0.01 vs placebo). Conclusions: Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.",
keywords = "ageing, bone density, dehydroepiandrosterone, fat mass, fat-free mass, prohormone, sex differences",
author = "Jankowski, {Catherine M.} and Pamela Wolfe and Schmiege, {Sarah J.} and Nair, {K Sreekumaran} and Sundeep Khosla and Jensen, {Michael Dennis} and {von Muhlen}, Denise and Laughlin, {Gail A.} and Donna Kritz-Silverstein and Jaclyn Bergstrom and Richele Bettencourt and Weiss, {Edward P.} and Villareal, {Dennis T.} and Kohrt, {Wendy M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/cen.13901",
language = "English (US)",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition

T2 - A pooled analysis of four clinical trials

AU - Jankowski, Catherine M.

AU - Wolfe, Pamela

AU - Schmiege, Sarah J.

AU - Nair, K Sreekumaran

AU - Khosla, Sundeep

AU - Jensen, Michael Dennis

AU - von Muhlen, Denise

AU - Laughlin, Gail A.

AU - Kritz-Silverstein, Donna

AU - Bergstrom, Jaclyn

AU - Bettencourt, Richele

AU - Weiss, Edward P.

AU - Villareal, Dennis T.

AU - Kohrt, Wendy M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. Design: Pooled analyses of data from four double-blinded, randomized controlled trials. Participants: Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. Measurements: Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). Results: Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0% ± 3.4%) and trochanter (0.5% ± 3.8%) BMD and maintained total hip BMD (0.0% ± 2.8%); men had no BMD benefit and a decrease in fat mass (−0.4 ± 2.6 kg; all P < 0.01 vs placebo). Conclusions: Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.

AB - Objective: Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. Design: Pooled analyses of data from four double-blinded, randomized controlled trials. Participants: Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. Measurements: Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). Results: Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0% ± 3.4%) and trochanter (0.5% ± 3.8%) BMD and maintained total hip BMD (0.0% ± 2.8%); men had no BMD benefit and a decrease in fat mass (−0.4 ± 2.6 kg; all P < 0.01 vs placebo). Conclusions: Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.

KW - ageing

KW - bone density

KW - dehydroepiandrosterone

KW - fat mass

KW - fat-free mass

KW - prohormone

KW - sex differences

UR - http://www.scopus.com/inward/record.url?scp=85058068296&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058068296&partnerID=8YFLogxK

U2 - 10.1111/cen.13901

DO - 10.1111/cen.13901

M3 - Article

C2 - 30421439

AN - SCOPUS:85058068296

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

ER -