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Effects of dehydroepiandrosterone replacement on vascular function in primary and secondary adrenal insufficiency: A randomized crossover trial

Rice, Sam P. L., Agarwal, Neera, Bolusani, Hemanth, Newcombe, Robert Gordon ORCID: https://orcid.org/0000-0003-4400-8867, Scanlon, Maurice Francis, Ludgate, Marian Elizabeth and Rees, Dafydd Aled ORCID: https://orcid.org/0000-0002-1165-9092 2009. Effects of dehydroepiandrosterone replacement on vascular function in primary and secondary adrenal insufficiency: A randomized crossover trial. Journal of Clinical Endocrinology & Metabolism 94 (6) , pp. 1966-1972. 10.1210/jc.2008-2636

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Abstract

Context: Patients with Addison’s disease and hypopituitarism have increased mortality, chiefly related to vascular disease. Both diseases are characterized by dehydroepiandrosterone (DHEA) deficiency, yet this is not usually corrected. It is unclear whether treatment of these conditions with DHEA improves cardiovascular risk. Objective: The aim of the study was to evaluate the effects of DHEA on arterial stiffness and endothelial function in subjects with Addison’s disease and hypopituitarism. Design and Intervention: Forty subjects (20 with Addison’s disease, 20 with panhypopituitarism) were assigned to consecutive 12-wk treatment periods of DHEA 50 mg or placebo in a randomized, double-blind, crossover design separated by an 8-wk washout. Main Outcome Measures: Primary outcome parameters were measures of arterial stiffness [augmentation index, central blood pressure, brachial and aortic pulse wave velocity (PWV)] and endothelial function. Serum androgens, anthropometry, and metabolic biochemistry (lipids, homeostasis model of assessment for insulin resistance, high sensitivity C-reactive protein, adiponectin, plasminogen activator inhibitor-1) were also assessed. Results: Despite normalization of DHEA sulfate, androstenedione, and testosterone (females), DHEA replacement did not affect augmentation index, aortic PWV, brachial PWV, central blood pressure, or endothelial function. DHEA did not affect any anthropometric or metabolic measures, apart from a small reduction in high-density lipoprotein cholesterol (−0.08 mmol/liter; P = 0.007; 95% confidence interval for the difference, −0.13 to −0.02 mmol/liter). Conclusions: Short-term DHEA supplementation does not significantly affect measures of arterial stiffness or endothelial function in patients with adrenal insufficiency.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Postgraduate Medical and Dental Education
Medicine
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
Publisher: The Endocrine Society
ISSN: 0021-972X
Last Modified: 07 Dec 2022 07:19
URI: https://orca.cardiff.ac.uk/id/eprint/29441

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