Sex‐specific Effects of DHEA on Bone Mineral Density and Body Composition: A Pooled Analysis of Four Clinical Trials

Abstract

Objective

Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex‐specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass, and fat‐free mass in older women and men enrolled in four similar clinical trials.

Design

Pooled analyses of data from four double‐blinded, randomized controlled trials.

Participants

Women (n=295) and men (n=290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months.

Measurements

12‐month changes in BMD, fat mass, fat‐free mass, and serum DHEA sulfate (DHEAS), (17)estradiol, testosterone, and insulin‐like growth factor‐1 (IGF‐1).

Results

Women on DHEA had increases (mean±SD; all p<0.001 vs placebo) in DHEAS (231±164 μg/dL), testosterone (18.6±20.9 μg/dL), (17)estradiol (8.7 ±11.0 pg/mL), and IGF‐1 (25.1±52.3 ng/mL), and men had increases in DHEAS (269.0±177 μg/dL; p<0.01), (17)estradiol (4.8±12.2 pg/m; p<0.01), and IGF‐1 (6.3±41.4 ng/mL; p<0.05). Women on DHEA had increases in lumbar spine (1.0%±3.4%) and trochanter (0.5%±3.8%) BMD and maintained total hip BMD (0.0%±2.8%); men had no BMD benefit and a decrease in fat mass (‐0.4±2.6 kg; all p<0.01 vs placebo).

Conclusions

DHEA therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are 1) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and 2) whether DHEA has a more favorable benefit‐to‐risk profile for women than estrogen therapy.

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