Gebre-Medhin G, Husebye E S, Mallmin H, Helström L, Berne C, Karlsson F A, Kämpe O
Departments of Medicine, University Hospital, Uppsala, Sweden.
Clin Endocrinol (Oxf). 2000 Jun;52(6):775-80. doi: 10.1046/j.1365-2265.2000.01017.x.
Patients with primary adrenocortical failure (Addison's disease) have abnormally low levels of DHEA and androgens relative to age. To define a suitable dose, the effect of oral dehydroepiandrosterone (DHEA) replacement therapy in women with Addison's disease (n = 9) was evaluated.
DHEA was administered as a daily oral dose of either 50 mg (n = 5) or 200 mg (n = 4). Blood sampling and measurements of insulin sensitivity (as measured with euglycemic insulin clamp technique) and body composition (as measured by dual energy X-ray absorptiometry) were performed before and during DHEA treatment and at a 3-month follow up.
DHEA and DHEA(S) levels were restored to normal in those patients receiving 50 mg whereas DHEA(S) level was slightly above the normal reference value in those receiving 200 mg. Circulating levels of androgens (androstenedione, testosterone and testosterone/SHBG ratio) were normalized in all patients. A slight rise in IGF-1 levels was seen in both groups as was a decrease in the levels of low and high density lipoproteins. No effect on blood glucose levels or insulin sensitivity was seen and no change of body composition was observed. No serious side-effects were seen, but some of the patients experienced increased apocrine sweat secretion (n = 7), itchy scalp (n = 2) and acne (n = 7), all of which were reversed when DHEA was discontinued.
A daily replacement dose of 50 mg of DHEA results in near physiological levels of DHEA, DHEA(S) androstenedione and testosterone in women with Addison's disease, without severe side-effects.
原发性肾上腺皮质功能减退症（艾迪生病）患者的脱氢表雄酮（DHEA）和雄激素水平相对于其年龄异常低下。为确定合适的剂量，评估了口服脱氢表雄酮（DHEA）替代疗法对艾迪生病女性患者（n = 9）的疗效。
DHEA以每日50 mg（n = 5）或200 mg（n = 4）的口服剂量给药。在DHEA治疗前、治疗期间及3个月随访时进行采血，并测量胰岛素敏感性（采用正常血糖胰岛素钳夹技术测量）和身体成分（采用双能X线吸收法测量）。
接受50 mg剂量的患者中，DHEA和硫酸脱氢表雄酮（DHEA(S)）水平恢复正常，而接受200 mg剂量的患者中，DHEA(S)水平略高于正常参考值。所有患者的循环雄激素水平（雄烯二酮、睾酮及睾酮/性激素结合球蛋白比值）均恢复正常。两组患者的胰岛素样生长因子-1（IGF-1）水平均略有升高，低密度脂蛋白和高密度脂蛋白水平均有所下降。未观察到对血糖水平或胰岛素敏感性有影响，身体成分也未发生变化。未出现严重副作用，但部分患者出现顶泌汗腺分泌增加（n = 7）、头皮瘙痒（n = 2）和痤疮（n = 7），停用DHEA后这些症状均消失。
对于艾迪生病女性患者，每日50 mg的DHEA替代剂量可使DHEA、DHEA(S)、雄烯二酮和睾酮水平接近生理水平，且无严重副作用。
