[脱氢表雄酮疗法对经血管造影证实的冠心病男性患者胰岛素抵抗和血脂的积极影响——初步研究]

[Positive effects of DHEA therapy on insulin resistance and lipids in men with angiographically verified coronary heart disease--preliminary study].

作者信息

Rabijewski Michał, Zgliczyński Wojciech

机构信息

Department of Endocrinology Medical Center of Postgraduate Education, Warsaw, Poland.

出版信息

Endokrynol Pol. 2005 Nov-Dec;56(6):904-10.

PMID:16821209

Abstract

OBJECTIVES

The aim of this study was to analyze the influence of DHEA therapy on insulin resistance (FIRI, FG/FI) and serum lipids in men with angiographically verified coronary heart disease (CHD).

MATERIAL AND METHODS

The study included thirty men aged 41-60 years (mean age 52+/-0.90 yr) with serum DHEA-S concentration<2000 microg/l, who were randomized into a double-blind, placebo-controlled, cross-over trial. Subjects completed the 80 days study of 40 days of 150 mg oral DHEA daily or placebo, and next groups were changed after 30 days of wash-out. Fasting early morning blood samples were obtained at baseline and after each treatment to determine serum hormones levels (testosterone, DHEA-S, LH, FSH estradiol and IGF-1) and also metabolic profile (total cholesterol, LDL-cholesterol, triglicerides, HDL-cholesterol, insulin, glucose, fasting insulin resistance index--FIRI and FG/FI ratio).

RESULTS

Administration of DHEA was associated with 4.5-fold increase in DHEA-S levels. Relative to baseline DHEA administration resulted in a decrease in insulin levels by 40% (p<0.005) and fasting insulin resistance index (FIRI) by 47% (p<0.004). Also total cholesterol levels and LDL-cholesterol levels decreased significantly (from 222.9+/-6.6 mg/dL to 207.4+/-6.6 mg/dL and from 143.9+/-6.9 mg/dL to 130.5+/-6.0 mg/dL respectively; p<0.05). Glucose levels dropped significant below baseline values after DHEA (p<0.001). Estrogen levels significantly increased after DHEA (p<0.05). While changes of serum concentrations of testosterone, LH, FSH, IGF-I, HDL-cholesterol, triglycerides were not statistical significant. Tolerance of the treatment was good and no adverse effects were observed.

CONCLUSIONS

DHEA therapy in dose of 150 mg daily during 40 days in men with DHEA levels<2000 microg/l decreased total cholesterol concentration, insulin and glucose levels and fasting insulin resistance index (FIRI). This therapy may be a beneficial against CHD risk factors.

摘要

目的

本研究旨在分析脱氢表雄酮（DHEA）治疗对经血管造影证实患有冠心病（CHD）男性的胰岛素抵抗（空腹胰岛素抵抗指数、空腹血糖/空腹胰岛素比值）和血脂的影响。

材料与方法

该研究纳入了30名年龄在41 - 60岁（平均年龄52±0.90岁）、血清脱氢表雄酮硫酸盐（DHEA - S）浓度<2000μg/L的男性，他们被随机分为双盲、安慰剂对照的交叉试验。受试者完成了为期80天的研究，其中40天每天口服150mg DHEA或安慰剂，在洗脱30天后两组进行更换。在基线期和每次治疗后采集清晨空腹血样，以测定血清激素水平（睾酮、DHEA - S、促黄体生成素、促卵泡生成素、雌二醇和胰岛素样生长因子 - 1）以及代谢指标（总胆固醇、低密度脂蛋白胆固醇、甘油三酯、高密度脂蛋白胆固醇、胰岛素、葡萄糖、空腹胰岛素抵抗指数——空腹胰岛素抵抗指数和空腹血糖/空腹胰岛素比值）。

结果

服用DHEA后DHEA - S水平增加了4.5倍。相对于基线，服用DHEA导致胰岛素水平降低40%（p<0.005），空腹胰岛素抵抗指数降低47%（p<0.004）。总胆固醇水平和低密度脂蛋白胆固醇水平也显著降低（分别从222.9±6.6mg/dL降至207.4±6.6mg/dL，从143.9±6.9mg/dL降至130.5±6.0mg/dL；p<0.05）。服用DHEA后血糖水平显著低于基线值（p<0.001）。服用DHEA后雌激素水平显著升高（p<0.05）。而血清睾酮、促黄体生成素、促卵泡生成素、胰岛素样生长因子 - I、高密度脂蛋白胆固醇、甘油三酯浓度的变化无统计学意义。治疗耐受性良好，未观察到不良反应。