Diamond P, Cusan L, Gomez J L, Bélanger A, Labrie F
Laboratory of Molecular Endocrinology, CHUL Research Center, Quebec, Canada.
J Endocrinol. 1996 Sep;150 Suppl:S43-50.
We have evaluated the effect of dehydroepiandrosterone (DHEA) replacement therapy in 60- to 70-year-old women (n = 15) who received a single daily percutaneous application of a 10% DHEA cream for 12 months. While anthropometric measurements showed no change in body weight, we observed a 9.8% decrease in subcutaneous skinfold thickness at 12 months (P < 0.05). This was confirmed by measurements of midthigh fat and muscle areas by computed tomography where a 3.8% decrease (P < 0.05) in femoral fat and a 3.5% increase (P < 0.05) in femoral muscular areas were observed at 12 months. There was no significant change in abdominal fat measurements but the waist-to-hip ratio was only 0.83 at the onset of treatment. These changes in body fat and muscular mass were associated with a 11% decrease (P < 0.05) in fasting plasma glucose and a 17% decrease (P < 0.05) in fasting insulin levels. Treatment with DHEA had no adverse effect on the lipid or lipoprotein profile. In fact, an overall trend towards a decrease in total cholesterol and its lipoprotein fractions was observed. Plasma triglycerides were not affected. Plasma high-density lipoprotein (HDL) cholesterol decreased by 8% but the ratio HDL/cholesterol was unchanged by DHEA treatment because of a parallel decrease in total cholesterol. The index of sebum secretion showed a 73% increase (P < 0.05) during the 12 months of DHEA therapy followed by a return to pretreatment values 3 months after cessation of therapy. At the same time, sex hormone-binding globulin levels decreased (P < 0.05) during treatment and returned to pretreatment values 3 months after the end of therapy. Serum gonadotropins were not changed by DHEA treatment. Although not significant, we observed a tendency towards an elevation in serum GH levels. Values of serum IGF-I remained unchanged while plasma IGF-binding protein-3 levels significantly decreased (P < 0.05) during treatment and returned to pretreatment values after cessation of DHEA therapy. The present data clearly indicate the beneficial effects of DHEA therapy in postmenopausal women through its transformation into androgens and/or estrogens in specific intracrine tissues without any significant side effects.
我们评估了脱氢表雄酮（DHEA）替代疗法对60至70岁女性（n = 15）的影响，这些女性每天经皮涂抹一次10%的DHEA乳膏，持续12个月。人体测量结果显示体重没有变化，但我们观察到12个月时皮下皮肤褶厚度下降了9.8%（P < 0.05）。通过计算机断层扫描测量大腿中部脂肪和肌肉面积得到了证实，12个月时股骨脂肪减少了3.8%（P < 0.05），股骨肌肉面积增加了3.5%（P < 0.05）。腹部脂肪测量没有显著变化，但治疗开始时腰臀比仅为0.83。身体脂肪和肌肉量的这些变化与空腹血糖水平下降11%（P < 0.05）和空腹胰岛素水平下降17%（P < 0.05）相关。DHEA治疗对血脂或脂蛋白谱没有不良影响。事实上，观察到总胆固醇及其脂蛋白组分总体呈下降趋势。血浆甘油三酯未受影响。血浆高密度脂蛋白（HDL）胆固醇下降了8%，但由于总胆固醇同时下降，DHEA治疗后HDL/胆固醇比值未变。皮脂分泌指数在DHEA治疗的12个月期间增加了73%（P < 0.05），治疗停止3个月后恢复到治疗前水平。同时，治疗期间性激素结合球蛋白水平下降（P < 0.05），治疗结束3个月后恢复到治疗前水平。DHEA治疗对血清促性腺激素没有影响。虽然不显著，但我们观察到血清GH水平有升高的趋势。血清IGF-I值保持不变，而血浆IGF结合蛋白-3水平在治疗期间显著下降（P < 0.05），DHEA治疗停止后恢复到治疗前水平。目前的数据清楚地表明，DHEA疗法在绝经后女性中具有有益作用，它可在特定的内分泌组织中转化为雄激素和/或雌激素，且无任何明显副作用。
