Maggio Marcello, De Vita Francesca, Fisichella Alberto, Colizzi Elena, Provenzano Sandra, Lauretani Fulvio, Luci Michele, Ceresini Graziano, Dall'Aglio Elisabetta, Caffarra Paolo, Valenti Giorgio, Ceda Gian Paolo
Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy; Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy.
Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy.
J Steroid Biochem Mol Biol. 2015 Jan;145:281-92. doi: 10.1016/j.jsbmb.2014.03.014. Epub 2014 May 2.
The adrenal prohormone dehydroepiandrosterone (DHEA) and its sulphate conjugate (DHEAS) steadily decrease with age by 10% per decade reaching a nadir after the age of 80. Both DHEA and DHEAS (DHEA/S) exert many biological activities in different tissues and organs. In particular, DHEA and DHEAS are produced de novo in the brain, hence their classification as neurosteroids. In humans, the brain-to-plasma ratios for DHEA and DHEAS are 4-6.5 and 8.5, respectively, indicating a specific neuroendocrine role for these hormones. DHEA/S stimulates neurite growth, neurogenesis and neuronal survival, apoptosis, catecholamine synthesis and secretion. Together with antioxidant, anti-inflammatory and anti-glucocorticoid properties, it has been hypothesized a neuroprotective effect for DHEA/S. We conducted an accurate research of the literature using PubMed. In the period of time between 1994 and 2013, we selected the observational human studies testing the relationship between DHEA/S and cognitive function in both sexes. The studies are presented according to the cross-sectional and longitudinal design and to the positive or neutral effects on different domains of cognitive function. We also analysed the Clinical Trials, available in the literature, having cognitive domains as the main or secondary outcome. Although the cross-sectional evidence of a positive association between DHEA/S and cognitive function, longitudinal studies and RCTs using DHEA oral treatment (50mg/day) in normal or demented adult-older subjects, have produced conflicting and inconsistent results. In summary, the current data do not provide clear evidence for the usefulness of DHEA treatment to improve cognitive function in adult-older subjects. This article is part of a Special Issue entitled 'Essential role of DHEA'.
肾上腺前体激素脱氢表雄酮（DHEA）及其硫酸酯共轭物（DHEAS）会随着年龄的增长而稳步下降，每十年下降10%，在80岁以后降至最低点。DHEA和DHEAS（DHEA/S）在不同的组织和器官中发挥着多种生物学活性。特别是，DHEA和DHEAS在大脑中从头合成，因此它们被归类为神经甾体。在人类中，DHEA和DHEAS的脑-血浆比值分别为4 - 6.5和8.5，这表明这些激素具有特定的神经内分泌作用。DHEA/S可刺激神经突生长、神经发生和神经元存活、细胞凋亡、儿茶酚胺合成与分泌。鉴于其具有抗氧化、抗炎和抗糖皮质激素特性，有人推测DHEA/S具有神经保护作用。我们使用PubMed对文献进行了精确检索。在1994年至2013年期间，我们选择了观察性人体研究，以测试DHEA/S与两性认知功能之间的关系。这些研究根据横断面和纵向设计以及对认知功能不同领域的正向或中性影响进行呈现。我们还分析了文献中以认知领域为主要或次要结局的临床试验。尽管有横断面证据表明DHEA/S与认知功能呈正相关，但在正常或患有痴呆的成年老年受试者中使用DHEA口服治疗（50mg/天）的纵向研究和随机对照试验产生了相互矛盾和不一致的结果。总之，目前的数据并未提供明确证据表明DHEA治疗对改善成年老年受试者的认知功能有用。本文是名为“DHEA的重要作用”的特刊的一部分。
