Department of Hypertension, Jinan Municipal Hospital of Traditional Chinese Medicine, No. 76, Gongqingtuan Road, Jinan City, Shandong Province, 250000, PR China.
School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
Nutr Metab Cardiovasc Dis. 2020 Aug 28;30(9):1465-1475. doi: 10.1016/j.numecd.2020.05.015. Epub 2020 Jun 3.
Dehydroepiandrosterone (DHEA) supplementation has gained attention in individuals with adrenal insufficiency, and as a tool for increasing androgens and estrogens whereby is proposed to improve the accretion of muscle and bone mass. However, DHEA supplementation has demonstrated negative effects on the lipid profile and, thus, we aimed to analyze the body of evidence in this regard.
A systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was performed employing in Scopus, PubMed/Medline, Web of Science, Embase and Google Scholar, then including relevant articles that addressed the effects of DHEA supplementation on the lipid profile, up to February 2020. Combined findings were generated from 23 eligible articles. Hence, total cholesterol (TC) (weighted mean difference (WMD): -3.5 mg/dl, 95% confidence interval (CI): -8.5 to 1.6)), low-density lipoprotein-cholesterol (LDL-C) (WMD: 0.34 mg/dl, 95% CI: -3 to 3.7) and triglycerides (TG) levels (WMD: -2.85 mg/dl, 95% CI: -9.3 to 3.6) did not alter in DHEA group compared to the control, but HDL-C levels significantly reduced in DHEA group (WMD: -3.1 mg/dl, 95% CI: -4.9 to -1.3). In addition, a significant reduction in HDL-C values was observed in studies comprising women (WMD: -5.1 mg/dl, 95% CI: -7.2 to -3) but not in males (WMD: 0.13 mg/dl, 95% CI: -1.4 to 1.7).
Overall, supplementation with DHEA did not change circulating values of TC, LDL-C and TG, whereas it may decrease HDL-C levels. Further long-term RCTs are required to investigate the effects of DHEA particularly on major adverse cardiac events.
脱氢表雄酮 (DHEA) 的补充已引起肾上腺功能不全患者的关注，并且作为增加雄激素和雌激素的工具，从而被提议改善肌肉和骨量的积累。然而，DHEA 的补充已显示出对脂质谱的负面影响，因此，我们旨在分析这方面的证据。
我们在 Scopus、PubMed/Medline、Web of Science、Embase 和 Google Scholar 中进行了系统评价和随机对照试验 (RCT) 的剂量反应荟萃分析，然后纳入了有关 DHEA 补充对脂质谱影响的相关文章，截至 2020 年 2 月。从 23 篇合格文章中得出综合结果。因此，与对照组相比，DHEA 组的总胆固醇 (TC) (加权均数差 (WMD): -3.5mg/dl, 95%置信区间 (CI): -8.5 至 1.6))、低密度脂蛋白胆固醇 (LDL-C) (WMD: 0.34mg/dl, 95% CI: -3 至 3.7) 和甘油三酯 (TG) 水平 (WMD: -2.85mg/dl, 95% CI: -9.3 至 3.6) 没有改变，但 DHEA 组的 HDL-C 水平显著降低 (WMD: -3.1mg/dl, 95% CI: -4.9 至 -1.3)。此外，在包含女性的研究中观察到 HDL-C 值显著降低 (WMD: -5.1mg/dl, 95% CI: -7.2 至 -3)，但在男性中则没有 (WMD: 0.13mg/dl, 95% CI: -1.4 至 1.7)。
总体而言，DHEA 的补充并未改变 TC、LDL-C 和 TG 的循环值，而可能降低 HDL-C 水平。需要进一步的长期 RCT 来研究 DHEA 对主要不良心脏事件的影响。
