Metabolic and Hormonal Effects of Oral DHEA in Premenopausal Women with HIV Infection: A Randomized, Prospective, Placebo-controlled Pilot Study

L. Poretsky; L. Song; D. J. Brillon; S. Ferrando; J. Chiu; M. McElhiney; A. Ferenczi; C. Sison; I. Haller; J. Rabkin

doi:10.1055/s-0028-1087175

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2009; 41(3): 244-249
DOI: 10.1055/s-0028-1087175

Humans, Clinical

Metabolic and Hormonal Effects of Oral DHEA in Premenopausal Women with HIV Infection: A Randomized, Prospective, Placebo-controlled Pilot Study

L. Poretsky¹ ^, ³ ^, ⁶ , L. Song⁶ , D. J. Brillon¹ ^, ³ , S. Ferrando² , J. Chiu⁴ , M. McElhiney⁴ , A. Ferenczi⁶ , C. Sison⁷ , I. Haller³ , J. Rabkin² ^, ⁴ ^, ⁵

¹Division of Endocrinology, Department of Medicine, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, USA
²Department of Psychiatry, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, USA
³General Clinical Research Center, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, USA
⁴New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, USA
⁵Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, USA
⁶Division of Endocrinology and Metabolism, Department of Medicine, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, USA
⁷Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Biostatistics Unit, Manhasset, New York, USA

Abstract

Women with HIV infection use dehydroepiandrosterone (DHEA) because of its potential effects on mood and energy. We examined the effects of DHEA on the hypothalamic–pituitary–adrenal and gonadal axes and on insulin sensitivity. Fifteen HIV-positive women were randomized to receive placebo (6 subjects) or oral DHEA (9 subjects). ACTH-, CRF-, and GnRH-stimulation tests were performed before and after 8 weeks of treatment. DHEA, DHEA-S, dihydrotestosterone, total testosterone, free testosterone, sex hormone–binding globulin, estrone, estradiol, cortisol, insulin, IGF-1, IGFBP-1, IGFBP-3, and adiponectin in plasma or serum were measured. There was a significant increase in DHEA (p<0.004), DHEA-S (p<0.008), total testosterone (p<0.008), dihydrotestosterone (p<0.004), androstenedione (p<0.04), and estrone (p<0.03) from baseline within the DHEA group but not within the placebo group. There was a significant increase in DHEA (p<0.0006), DHEA-S (p<0.032), total testosterone (p<0.01), and dihydrotestosterone (p<0.005) in the DHEA group compared with the placebo group. Oral DHEA produces significant increases in circulating DHEA, DHEA-S, testosterone, DHT, and, possibly, androstenedione and estrone levels in premenopausal women with HIV infection. In the current pilot study these hormone changes did not affect the pituitary or adrenal axis or insulin/IGF indices. Long-term studies with larger groups of patients are needed to confirm these data and to determine their clinical significance.

Key words

endocrine effects - DHEA - HIV infection - premenopausal women - insulin sensitivity

Full Text

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Correspondence

L. PoretskyMD

Division of Endocrinology and Metabolism

Beth Israel Medical Center

317 East 17th Street

10003 New York

Phone: + 1/212/420 46 66

Fax: +1/212/420 22 24

Email: lporetsk@chpnet.org