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Effects of dehydroepiandrosterone sulphate ( DHEAS ) replacement on insulin action and quality of life in hypopituitary females: a double‐blind, placebo‐controlled study
Author(s) -
McHenry Claire M.,
Bell Patrick M.,
Hunter Steven J.,
Thompson Christopher J.,
Courtney C. H.,
Ennis Cieran N.,
Sheridan Brian,
McCance David R.,
Mullan Karen R.,
Atkinson A. Brew
Publication year - 2012
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2012.04356.x
Subject(s) - endocrinology , medicine , placebo , insulin , dehydroepiandrosterone sulfate , crossover study , sex hormone binding globulin , dehydroepiandrosterone , pancreatic hormone , testosterone (patch) , glucose clamp technique , insulin resistance , androgen , hormone , alternative medicine , pathology
Summary Objective Addition of dehydroepiandrosterone sulphate ( DHEAS ) to standard pituitary replacement may improve quality of life and glucose metabolism. Conflicting results from the previous work probably relate to differences in populations studied and assessment techniques used. We examined the effects of DHEAS on insulin action and the quality of life in female patients with hypopituitary hypoadrenalism. Design Randomized, double‐blind, placebo‐controlled, crossover design was used. Patients received either DHEAS 50 mg daily or placebo for 12 weeks. Patients Fourteen hypopituitary females on stable standard replacement therapy and with low DHEAS were enrolled. Measurements Insulin action by euglycaemic hyperinsulinaemic clamp and extensive quality of life parameters were assessed after each treatment. Results Serum DHEAS ( DHEAS 5·4 ± 0·8 vs placebo <0·8 ± 0·0 μ m ; P < 0·001) and androstenedione ( DHEAS 4·1 ± 0·8 vs placebo 1·3 ± 0·2 n m ; P < 0·05) rose to within the normal range after DHEAS 50 mg daily. There were no differences between treatments in testosterone, sex hormone‐binding globulin ( SHBG ) or IGF ‐1. Quality of life measures were unchanged after DHEAS . There were no differences between treatments in fasting glucose, serum insulin, HbA1c or in insulin action (glucose infusion rates required to maintain euglycaemia; DHEAS 21·9 ± 2·5 vs placebo 24·5 ± 2·1 μmol/kg/min; P = 0·4). Triglyceride concentrations were lower following DHEAS ( DHEAS 1·24 ± 0·18 vs placebo 1·41 ± 0·19 m m ; P < 0·05) but other lipid parameters remained unchanged. Conclusion There were no differences compared with placebo in quality of life or insulin action after DHEAS replacement therapy for 12 weeks. These results do not provide evidence for the addition of DHEAS to standard hypopituitary replacement therapy.