Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men

Abstract

Context Dehydroepiandrosterone (DHEA) administration has been shown to reduce accumulation of abdominal visceral fat and protect against insulin resistance in laboratory animals, but it is not known whether DHEA decreases abdominal obesity in humans. DHEA is widely available as a dietary supplement without a prescription.Objective To determine whether DHEA replacement therapy decreases abdominal fat and improves insulin action in elderly persons. Design and SettingRandomized, double-blind, placebo-controlled trial conducted in a US university-based research center from June 2001 to February 2004. Participants Fifty-six elderly persons (28 women and 28 men aged 71 [range, 65-78] years) with age-related decrease in DHEA level.Intervention Participants were randomly assigned to receive 50 mg/d of DHEA or matching placebo for 6 months. Main Outcome MeasuresThe primary outcome measures were 6-month change in visceral and subcutaneous abdominal fat measured by magnetic resonance imaging and glucose and insulin responses to an oral glucose tolerance test (OGTT). ResultsOf the 56 men and women enrolled, 52 underwent follow-up evaluations. Compliance with the intervention was 97% in the DHEA group and 95% in the placebo group. Based on intention-to-treat analyses, DHEA therapy compared with placebo induced significant decreases in visceral fat area (-13 cm 2 vs +3 cm 2 , respectively; P = .001) and subcutaneous fat (-13 cm 2 vs +2 cm 2 , P = .003). The insulin area under the curve (AUC) during the OGTT was significantly reduced after 6 months of DHEA therapy compared with placebo (-1119 µU/mL per 2 hours vs +818 µU/mL per 2 hours, P = .007). Despite the lower insulin levels, the glucose AUC was unchanged, resulting in a significant increase in an insulin sensitivity index in response to DHEA compared with placebo (+1.4 vs -0.7, P = .005). ConclusionDHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity.

Effects of dehydroepiandrosterone on growth performance, lipid metabolic hormones and parameters in broilers

“…Furthermore, in our early research, we found that chickens fed DHEA exhibited decreased body weight and abdominal fat weight with no significant difference in breast and leg muscle weight (Tang et al, 2007). This was in accordance with previous reports that found that DHEA administration reduced abdominal fat accumulation in both rats (Cleary and Zisk, 1986) and elderly women and men (Villareal and Holloszy, 2004). Few studies have reported the effects of DHEA on poultry growth performance or carcass composition.…”

Dehydroepiandrosterone increases β‐cell mass and improves the glucose‐induced insulin secretion by pancreatic islets from aged rats

“…Administration of DHEA to rats and mice reduces visceral adipose tissue accumulation, and has a protective effect against insulin resistance that occurs with aging. DHEA also has been described to enhance insulin release and protect pancreatic islets from the cytotoxicity effects of interleukin1b and streptozotocin [9][10][11][12][13][14][15][16][17][18][19][20]. However, the mechanisms underlying the effects of DHEA on insulin release and pancreatic islet survival are not completed understood.…”

Androgen therapy in women

“…There are very consistent reports of significant decreases in HDL cholesterol following DHEA replacement. Two recent studies reported an improvement in some parameters of insulin sensitivity following 12 weeks of DHEA replacement in adrenal insufficiency (50) and six months of DHEA in elderly women (51). The latter study also reported a significant decrease in fat mass as assessed by magnetic resonance imaging (MRI) in 14 women treated for six months (51).…”