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

Brooke, Antonia; Kalingag, Leonila A.; Miraki-Moud, Farideh; Camacho‐Hübner, Cecilia; Maher, K. T.; Walker, Deward E.; Hinson, J. P.; Monson, John P.

doi:10.1111/j.1365-2265.2006.02648.x

Cited by 22 publications

(14 citation statements)

References 42 publications

(98 reference statements)

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“…This effect on lipid metabolism might be mediated by an increase in hepatic lipase activity and consecutively impaired hepatic cholesterol formation [53]. One of the most consistent observations is the increase in serum IGF-I levels, with the most significant change observed in women under DHEA replacement [48,56]. This has clinical implications in patients receiving growth hormone replacement in which reduction of the growth hormone dose may be necessary.…”

Section: Metabolic and Cardiovascular Effects Of Dhea In Adrenal Insumentioning

confidence: 95%

Is DHEA replacement beneficial in chronic adrenal failure?

Lang

Burger-Stritt

Hahner

2015

Best Practice & Research Clinical Endocrinology & Metab

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Section: Metabolic and Cardiovascular Effects Of Dhea In Adrenal Insumentioning

confidence: 95%

Is DHEA replacement beneficial in chronic adrenal failure?

Lang

Burger-Stritt

Hahner

2015

Best Practice & Research Clinical Endocrinology & Metab

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“…Androgen levels are also reduced in hypopituitary women, especially in the setting of combined hypogonadotropic hypogonadism and ACTH deficiency [14]. While initial evidence suggests that androgen replacement may be useful in hypopituitary women [15,16], it has not yet become part of standard practice. Untreated oestrogen deficiency contributes to reduction in BMD, but the route of oestrogen replacement also has implications for body composition.…”

Section: Baseline Evaluationmentioning

confidence: 95%

Management of growth hormone deficiency in adults

Nilsson

Svensson

Johannsson

2007

Growth Hormone & IGF Research

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“…Female patients on oestrogen require a higher GH dose to achieve the same serum IGF-I [46,47]. Testosterone and DHEAS have been shown to increase IGF-I in the context of GH replacement [47][48][49].…”

Section: Long-term Monitoring Of Persisting Diseasementioning

confidence: 97%

Serum IGF-I levels in the diagnosis and monitoring of acromegaly

Brooke

Drake

2007

Pituitary

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Insulin-Like Growth Factor-I (IGF-I) is a reliable marker of disease activity and growth hormone (GH) status in acromegaly, but its clinical utility has been hampered over the years by various issues including a lack of robust reference range data and variability in assay sensitivity and specificity. In acromegaly IGF-I correlates well with GH activity and nadir GH on oral glucose tolerance test (OGTT) and is the most sensitive and specific test in diagnosis, where serum IGF-I is persistently seen to be elevated to a range that is distinct from that in healthy individuals. However it should not be relied on exclusively for diagnosis or used as the sole indication of disease severity and GH burden. Successful medical or surgical treatment of acromegaly is usually associated with normalisation of serum IGF-I but there is discordance between GH and IGF-I in some patients. Patients with a normal IGF-I but an abnormal GH suppression to OGTT are at risk of relapse and therefore it should not be used alone to establish disease remission. In contrast to the diagnosis of acromegaly, there is also considerable overlap in serum IGF-I with normality after primary treatment of disease, even in the presence of persisting GH excess. Gender, age and prior radiotherapy alters the relationship between GH and IGF-I and reliance on one marker of disease activity such as IGF-I is particularly precarious in certain disease states. However an elevated serum IGF-I has been shown to be associated with excess mortality and normalising IGF-I normalises mortality making it a useful marker. The tightening up of the assays means that establishing absolute concentrations as well as standard deviation scores are essential to allow cross-study comparisons. This becomes especially important in the use of Pegvisomant, where IGF-I becomes the sole biochemical marker of disease activity.

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

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

Cited by 22 publications

References 42 publications

Is DHEA replacement beneficial in chronic adrenal failure?

Is DHEA replacement beneficial in chronic adrenal failure?

Management of growth hormone deficiency in adults

Serum IGF-I levels in the diagnosis and monitoring of acromegaly

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