J Clin Endocrinol Metab. 2006 May 30; [Epub ahead of print]

Effects of DHEA Replacement Therapy on Bone Mineral Density in Older
{*filter*}s: A Randomized, Controlled Trial.

Jankowski CM, Gozansky WS, Schwartz RS, Dahl DJ, Kittelson JM, Scott SM,
Pelt RE, Kohrt WM.

Division of Geriatric Medicine, Department of Medicine, University of
Colorado at Denver and Health Sciences Center, Denver, CO; Department of
Preventive Medicine and Biometrics, University of Colorado at Denver and
Health Sciences Center, Denver, CO; Department of Obstetrics and
Gynecology, University of Colorado at Denver and Health Sciences Center,
Denver, CO.

Context Dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) decrease with
aging and are important androgen and estrogen precursors in older {*filter*}s.
Declines in DHEAS with aging may contribute to physiological changes that
are sex hormone-dependent. Objective The aim was to determine whether DHEA
replacement increases bone mineral density (BMD) and fat-free mass. Design,
Setting, Participants A randomized, double-blinded, controlled trial was
conducted at an academic research institution. Participants were 70 women
and 70 men, aged 60-88 yr, with low serum DHEAS levels. Intervention The
intervention was {*filter*}DHEA 50 mg/d or placebo for 12 months. Measurements
BMD, fat mass, and fat-free mass were measured before and after
intervention. Results Intent-to-treat analyses revealed trends for DHEA to
increase BMD more than placebo at the total hip (1.0%, P = 0.05),
trochanter (1.2%, P = 0.06), and shaft (1.2%, P = 0.05). In women only,
DHEA increased lumbar spine BMD (2.2%, P = 0.04; sex-by-treatment
interaction, P = 0.05). In secondary compliance analyses, BMD increases in
hip regions were significant (1.2-1.6%; all P < 0.02) in the DHEA group.
There were no significant effects of DHEA on fat or fat-free mass in
intent-to-treat or compliance analyses. Conclusions DHEA replacement
therapy for 1 yr improved hip BMD in older {*filter*}s and spine BMD in older
women. Because there have been few randomized controlled trials of the
effects of DHEA therapy, these findings support the need for further
investigations of the benefits and risks of DHEA replacement and the
mechanisms for its actions.