Effects of DHEA replacement on vascular function in primary and secondary adrenal insufficiency: a randomized crossover trial Export

@article{citeulike:4301631, abstract = {Context: Patients with Addison's disease and hypopituitarism have increased mortality, chiefly related to vascular disease. Both diseases are characterized by DHEA(S) deficiency yet this is not usually corrected. It is unclear whether treatment of these conditions with DHEA improves cardiovascular risk.Objective: To evaluate the effects of DHEA on arterial stiffness and endothelial function in subjects with Addison's disease and hypopituitarism.Design and Intervention: 40 subjects (20 Addison's disease, 20 panhypopituitarism) were assigned to consecutive 12-week treatment periods of DHEA 50mg or placebo in a randomized, double-blind, crossover design, separated by an 8-week washout.Main Outcome Measures: Primary outcome parameters were measures of arterial stiffness [augmentation index (AIx), central blood pressure, brachial and aortic pulse wave velocity (b/aPWV)] and endothelial function. Serum androgens, anthropometry and metabolic biochemistry [lipids, HOMA-IR, high sensitivity CRP, adiponectin, plasminogen activator inhibitor-1] were also assessed.Results: Despite normalization of DHEAS, androstenedione and testosterone (females), DHEA replacement did not affect AIx, aPWV, bPWV, central blood pressure or endothelial function. DHEA did not affect any anthropometric or metabolic measures, apart from a small reduction in HDL cholesterol (-0.08 mmol/l, p=0.007, 95\% CI for the difference -0.13 to -0.02 mmol/l).Conclusions: Short-term DHEA supplementation does not significantly affect measures of arterial stiffness or endothelial function in patients with adrenal insufficiency. 10.1210/jc.2008-2636}, author = {Rice, Sam P. and Agarwal, Neera and Bolusani, Hemanth and Newcombe, Robert and Scanlon, Maurice F. and Ludgate, Marian and Rees, Aled D.}, citeulike-article-id = {4301631}, citeulike-linkout-0 = {http://dx.doi.org/10.1210/jc.2008-2636}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19318448}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19318448}, day = {24}, doi = {10.1210/jc.2008-2636}, journal = {J Clin Endocrinol Metab}, keywords = {adrenal, androgen, therapy, vasculardisease}, month = {March}, pages = {jc.2008-2636+}, posted-at = {2009-04-11 16:18:23}, priority = {2}, title = {Effects of DHEA replacement on vascular function in primary and secondary adrenal insufficiency: a randomized crossover trial}, url = {http://dx.doi.org/10.1210/jc.2008-2636}, year = {2009} }

TY - JOUR ID - citeulike:4301631 L3 - citeulike-article-id:4301631 N2 - Context: Patients with Addison's disease and hypopituitarism have increased mortality, chiefly related to vascular disease. Both diseases are characterized by DHEA(S) deficiency yet this is not usually corrected. It is unclear whether treatment of these conditions with DHEA improves cardiovascular risk.Objective: To evaluate the effects of DHEA on arterial stiffness and endothelial function in subjects with Addison's disease and hypopituitarism.Design and Intervention: 40 subjects (20 Addison's disease, 20 panhypopituitarism) were assigned to consecutive 12-week treatment periods of DHEA 50mg or placebo in a randomized, double-blind, crossover design, separated by an 8-week washout.Main Outcome Measures: Primary outcome parameters were measures of arterial stiffness [augmentation index (AIx), central blood pressure, brachial and aortic pulse wave velocity (b/aPWV)] and endothelial function. Serum androgens, anthropometry and metabolic biochemistry [lipids, HOMA-IR, high sensitivity CRP, adiponectin, plasminogen activator inhibitor-1] were also assessed.Results: Despite normalization of DHEAS, androstenedione and testosterone (females), DHEA replacement did not affect AIx, aPWV, bPWV, central blood pressure or endothelial function. DHEA did not affect any anthropometric or metabolic measures, apart from a small reduction in HDL cholesterol (-0.08 mmol/l, p=0.007, 95% CI for the difference -0.13 to -0.02 mmol/l).Conclusions: Short-term DHEA supplementation does not significantly affect measures of arterial stiffness or endothelial function in patients with adrenal insufficiency. 10.1210/jc.2008-2636 JF - J Clin Endocrinol Metab TI - Effects of DHEA replacement on vascular function in primary and secondary adrenal insufficiency: a randomized crossover trial SP - jc.2008-2636 KW - adrenal KW - androgen KW - therapy KW - vasculardisease AU - Rice, Sam AU - Agarwal, Neera AU - Bolusani, Hemanth AU - Newcombe, Robert AU - Scanlon, Maurice AU - Ludgate, Marian AU - Rees, Aled PY - 2009/03/24/ UR - http://dx.doi.org/10.1210/jc.2008-2636 ER -