Nair K Sreekumaran, Rizza Robert A, O'Brien Peter, Dhatariya Ketan, Short Kevin R, Nehra Ajay, Vittone Janet L, Klee George G, Basu Ananda, Basu Rita, Cobelli Claudio, Toffolo Gianna, Dalla Man Chiara, Tindall Donald J, Melton L Joseph, Smith Glenn E, Khosla Sundeep, Jensen Michael D
Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA.
N Engl J Med. 2006 Oct 19;355(16):1647-59. doi: 10.1056/NEJMoa054629.
Dehydroepiandrosterone (DHEA) and testosterone are widely promoted as antiaging supplements, but the long-term benefits, as compared with potential harm, are unknown.
We performed a 2-year, placebo-controlled, randomized, double-blind study involving 87 elderly men with low levels of the sulfated form of DHEA and bioavailable testosterone and 57 elderly women with low levels of sulfated DHEA. Among the men, 29 received DHEA, 27 received testosterone, and 31 received placebo. Among the women, 27 received DHEA and 30 received placebo. Outcome measures included physical performance, body composition, bone mineral density (BMD), glucose tolerance, and quality of life.
As compared with the change from baseline to 24 months in the placebo group, subjects who received DHEA for 2 years had an increase in plasma levels of sulfated DHEA by a median of 3.4 microg per milliliter (9.2 micromol per liter) in men and by 3.8 microg per milliliter (10.3 micromol per liter) in women. Among men who received testosterone, the level of bioavailable testosterone increased by a median of 30.4 ng per deciliter (1.1 nmol per liter), as compared with the change in the placebo group. A separate analysis of men and women showed no significant effect of DHEA on body-composition measurements. Neither hormone altered the peak volume of oxygen consumed per minute, muscle strength, or insulin sensitivity. Men who received testosterone had a slight increase in fat-free mass, and men in both treatment groups had an increase in BMD at the femoral neck. Women who received DHEA had an increase in BMD at the ultradistal radius. Neither treatment improved the quality of life or had major adverse effects.
Neither DHEA nor low-dose testosterone replacement in elderly people has physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life. (ClinicalTrials.gov number, NCT00254371 [ClinicalTrials.gov].).
脱氢表雄酮（DHEA）和睾酮作为抗衰老补充剂被广泛推广，但与潜在危害相比，其长期益处尚不清楚。
我们进行了一项为期2年的安慰剂对照、随机、双盲研究，纳入了87名硫酸化形式的DHEA和生物可利用睾酮水平较低的老年男性以及57名硫酸化DHEA水平较低的老年女性。在男性中，29人接受DHEA，27人接受睾酮，31人接受安慰剂。在女性中，27人接受DHEA，30人接受安慰剂。观察指标包括身体机能、身体成分、骨矿物质密度（BMD）、糖耐量和生活质量。
与安慰剂组从基线到24个月的变化相比，接受DHEA治疗2年的男性受试者血浆硫酸化DHEA水平中位数增加了3.4微克/毫升（9.2微摩尔/升），女性增加了3.8微克/毫升（10.3微摩尔/升）。在接受睾酮治疗的男性中，生物可利用睾酮水平中位数增加了30.4纳克/分升（1.1纳摩尔/升），与安慰剂组的变化相比。对男性和女性的单独分析显示，DHEA对身体成分测量无显著影响。两种激素均未改变每分钟耗氧量峰值、肌肉力量或胰岛素敏感性。接受睾酮治疗的男性去脂体重略有增加，两个治疗组的男性股骨颈骨密度均有所增加。接受DHEA治疗的女性超远端桡骨骨密度增加。两种治疗均未改善生活质量，也未产生重大不良反应。
老年人补充DHEA或低剂量睾酮替代疗法对身体成分、身体机能、胰岛素敏感性或生活质量均无生理相关的有益影响。（临床试验注册号，NCT00254371 [ClinicalTrials.gov]。）
