DHEA in elderly women and DHEA or testosterone in elderly men.

KS Nair — 2007-10-21T23:39:35-00:00

N Engl J Med, Vol. 355, No. 16. (19 October 2006), pp. 1647-1659.

BACKGROUND: Dehydroepiandrosterone (DHEA) and testosterone are widely promoted as antiaging supplements, but the long-term benefits, as compared with potential harm, are unknown. METHODS: We performed a 2-year, placebo-controlled, randomized, double-blind study involving 87 elderly men with low levels of the sulfated form of DHEA and bioavailable testosterone and 57 elderly women with low levels of sulfated DHEA. Among the men, 29 received DHEA, 27 received testosterone, and 31 received placebo. Among the women, 27 received DHEA and 30 received placebo. Outcome measures included physical performance, body composition, bone mineral density (BMD), glucose tolerance, and quality of life. RESULTS: As compared with the change from baseline to 24 months in the placebo group, subjects who received DHEA for 2 years had an increase in plasma levels of sulfated DHEA by a median of 3.4 microg per milliliter (9.2 micromol per liter) in men and by 3.8 microg per milliliter (10.3 micromol per liter) in women. Among men who received testosterone, the level of bioavailable testosterone increased by a median of 30.4 ng per deciliter (1.1 nmol per liter), as compared with the change in the placebo group. A separate analysis of men and women showed no significant effect of DHEA on body-composition measurements. Neither hormone altered the peak volume of oxygen consumed per minute, muscle strength, or insulin sensitivity. Men who received testosterone had a slight increase in fat-free mass, and men in both treatment groups had an increase in BMD at the femoral neck. Women who received DHEA had an increase in BMD at the ultradistal radius. Neither treatment improved the quality of life or had major adverse effects. CONCLUSIONS: Neither DHEA nor low-dose testosterone replacement in elderly people has physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life. (ClinicalTrials.gov number, NCT00254371 [ClinicalTrials.gov].).

Effects of Two Years of Testosterone Replacement on Insulin Secretion, Insulin Action, Glucose Effectiveness, Hepatic Insulin Clearance and Postprandial Glucose Turnover in Elderly Men.

Rita Basu — 2007-05-24T17:00:08-00:00

Diabetes Care (11 May 2007)

Objective: To determine if, and if so the mechanism by which, testosterone replacement improves carbohydrate tolerance. Research Design and Methods: Fifty-five elderly men with relative testosterone deficiency ingested a labeled mixed meal and underwent a frequently sampled labeled IVGTT before and after treatment with either placebo or testosterone patch (5 mg/day) for two years. Results: Despite restoring bioavailable testosterone to values observed in young men, the change (24 month minus baseline values) in fasting and postprandial glucose, insulin, C-peptide concentrations, meal appearance, glucose disposal and endogenous glucose production were virtually identical to those observed after two years of placebo. The change over time in insulin and C-peptide concentrations post intravenous glucose injection also did not differ. Furthermore, the change over time in insulin action and glucose effectiveness (measured with the unlabeled and labeled "oral" and "intravenous" minimal models), as well as insulin secretion and hepatic insulin clearance (measured with the C-peptide model) did not differ in the testosterone and placebo groups. Conclusions: We conclude that two years of treatment of elderly men with testosterone does not improve carbohydrate tolerance nor does it alter insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance or the pattern of postprandial glucose metabolism. Thus testosterone deficiency is unlikely to be the cause of the age associated deterioration in glucose tolerance commonly observed in elderly men.

CiteULike: omalbams Nair

DHEA in elderly women and DHEA or testosterone in elderly men.

Effects of Two Years of Testosterone Replacement on Insulin Secretion, Insulin Action, Glucose Effectiveness, Hepatic Insulin Clearance and Postprandial Glucose Turnover in Elderly Men.