Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men

Synopsis:Administration of 50 mg of DHEA to elderly men and women for 6 months improved insulin action and decreased abdominal fat.

Source: Villareal DT, Holloszy JO. JAMA. 2004;292: 2243-2248.

Abdominal fat increases with advancing age and has been linked to increased risk for diabetes and cardiovascular disease. While insufficient exercise and overeating certainly contribute to age-related acquisition of abdominal fat, hormonal and metabolic factors also have been implicated. Even thin individuals who exercise regularly display increased abdominal fat as they age. This study aimed to determine whether the age-related decline in the adrenal hormone dehydroepiandrosteroine (DHEA) was one of the hormonal factors linked to increased abdominal adiposity and insulin resistance.

Elderly men (n = 28) and women (n = 28) between the ages of 65 to 78 years were enrolled and randomly assigned to receive either placebo or 50 mg of DHEA orally each day for 6 months. The mean body mass index of the men was 28 kg/m² and that of the women was 27 kg/m². Those using other hormones and having serious illnesses were excluded. Primary outcome variables were visceral and subcutaneous abdominal fat measured by magnetic resonance imaging and glucose and insulin responses to an oral glucose tolerance test. Ancillary outcome variables included food intake and levels of IGF-1, PSA, estradiol, and testosterone.

DHEA administration raised participants' serum DHEA-sulfate (DHEAS) into the young physiological range. In women, DHEA use increased testosterone and estradiol, but only estradiol was raised in men. Both groups showed increased IGF-1. SHBG did not change. Those who used DHEA lost about 2 pounds over the 6 months. Weight loss was similar in men and women. Recorded food intake stayed the same. Both men and women lost abdominal visceral fat, but women lost slightly more than men, 10 vs 7%. Abdominal fat declined 6% in both men and women. Insulin sensitivity improved dramatically and there was an inverse association between changes in insulin sensitivity and visceral fat. There were no adverse events and PSA did not change appreciably in men. Villareal and associates point out that the long-term safety of DHEA use remains unknown. However, based on the outcome variables followed in the study, short-term use appears to positively effect metabolism.