Effect of Dehydroepiandrosterone and Testosterone Supplementation on Systemic Lipolysis

Abstract

Context: Dehydroepiandrosterone (DHEA) and T hormones are advertised as antiaging, antiobesity products. However, the evidence that these hormones have beneficial effects on adipose tissue metabolism is limited.

Objective: The objective of the study was to determine the effect of DHEA and T supplementation on systemic lipolysis during a mixed-meal tolerance test (MMTT) and an iv glucose tolerance test (IVGTT).

Design: This was a 2-year randomized, double-blind, placebo-controlled trial.

Setting: The study was conducted at a general clinical research center.

Participants: Sixty elderly women with low DHEA concentrations and 92 elderly men with low DHEA and bioavailable T concentrations participated in the study.

Interventions: Elderly women received 50 mg DHEA (n = 30) or placebo (n = 30). Elderly men received 75 mg DHEA (n = 30), 5 mg T (n = 30), or placebo (n = 32).

Main outcome measures: In vivo measures of systemic lipolysis (palmitate rate of appearance) during a MMTT or IVGTT.

Results: At baseline there was no difference in insulin suppression of lipolysis measured during MMTT and IVGTT between the treatment groups and placebo. For both sexes, a univariate analysis showed no difference in changes in systemic lipolysis during the MMTT or IVGTT in the DHEA group and T group when compared with placebo. There was no change in the results after adjusting for the resting energy expenditure, except for a small, but significant (P = .03) lowering of MMTT nadir palmitate rate of appearance in women who received DHEA.

Conclusion: In elderly individuals with concentrations of DHEA (men and women) or T (men) below the normal range for young adults, supplementation of these hormones has no effect on insulin suppression of systemic lipolysis.

Trial registration: ClinicalTrials.gov NCT00254371.

Figures

Figure 1.. Palmitate Ra at baseline and after 2 years of hormone replacement (follow-up) according to treatment group during the MMTT (left panel) and during the IVGTT (right panel).

Figure 2.. Insulin concentrations in the participants in these studies.

P, placebo.

Figure 3.. Correlations between REE and palmitate release rate during a MMTT and IVGTT.

r, Pearson's correlation coefficient; rs, Spearman's correlation coefficient.

Figure 4.. Unadjusted change in nadir palmitate Ra at 24 months (baseline follow-up) according to treatment group.

The dashed lines indicate the change in palmitate Ra of ±10 μmol/min (from post hoc power calculation) in the treatment groups compared with placebo, necessary to detect a statistically significant difference.