Dehydroepiandrosterone sulphate and dehydroepiandrosterone in serum: differences related to age and sex

Carlström, Kjell; Brody, Samuel D.; Lunell, Nils‐Olov; Lagrelius, A.; Möllerström, Gunnar; Pousette, Åke; Rannevik, Gunnar; Stege, Reinhard; Schoultz, Bo von

doi:10.1016/0378-5122(88)90065-5

Cited by 98 publications

(48 citation statements)

References 26 publications

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“…(ii) A second modality for a DHEA trial would be to select, from among apparently ''normal'' individuals, those having the lowest concentration of DHEAS, for instance under the lowest quartile, and then to determine the possible effect of the correction of particularly low DHEAS concentrations, such as those observed in epidemiological studies (25)(26)(27), where they were associated with some behavioral problems and even to an increased rate of mortality in men. This type of trial, then, points to the possible responsibility of the lowest DHEAS levels, thus considered as ''pathological'' in contrast to the physiologically low DHEAS discussed in the previous paragraph.…”

Section: Discussionmentioning

confidence: 99%

Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue

Baulieu

Thomas

Legrain

et al. 2000

Proc. Natl. Acad. Sci. U.S.A.

538

253

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The secretion and the blood levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) decrease profoundly with age, and the question is posed whether administration of the steroid to compensate for the decline counteracts defects associated with aging. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States creates a real public health problem that may be resolved only by appropriate long-term clinical trials in elderly men and women. Two hundred and eighty healthy individuals (women and men 60 -79 years old) were given DHEA, 50 mg, or placebo, orally, daily for a year in a double-blind, placebo-controlled study. No potentially harmful accumulation of DHEAS and active steroids was recorded. Besides the reestablishment of a ''young'' concentration of DHEAS, a small increase of testosterone and estradiol was noted, particularly in women, and may be involved in the significantly demonstrated physiological-clinical manifestations here reported. Bone turnover improved selectively in women >70 years old, as assessed by the dual-energy x-ray absorptiometry (DEXA) technique and the decrease of osteoclastic activity. A significant increase in most libido parameters was also found in these older women. Improvement of the skin status was observed, particularly in women, in terms of hydration, epidermal thickness, sebum production, and pigmentation. A number of biological indices confirmed the lack of harmful consequences of this 50 mg͞day DHEA administration over one year, also indicating that this kind of replacement therapy normalized some effects of aging, but does not create ''supermen͞women'' (doping). C urrently, many strategies for delaying͞diminishing physiological deficits associated with aging are offered to a public, whose mean life expectancy is increasing, without appropriate scientific justifications and͞or medical precautions. Because of the profound age-related decrease of blood levels of the steroid dehydroepiandrosterone (DHEA; prasterone) and its sulfate ester (DHEAS), both essentially secreted by adrenals in human beings (1-5), it has been suggested that there is an ''adrenopause'' characterized by low value of blood DHEA(S) with maintenance of cortisol level. If this condition is involved in some impairment of health, the compensatory administration of DHEA may be of benefit, as is estrogen in women after menopause. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States (because of passage of the Dietary Supplement Health and Education Act of 1994) creates a real public health problem. Not only may the quality of, and sometimes the very presence of, DHEA in some samples on sale in supplement stores or supermarkets be questioned, but the usage of a product in the absence of medical indication and supervision could be improper for a number of consumers. Extravagant publicity based on fantasy (''fountain of youth,'' ''miracle pill'') or pseudoscientific assertion (''moth...

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Section: Discussionmentioning

confidence: 99%

Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue

Baulieu

Thomas

Legrain

et al. 2000

Proc. Natl. Acad. Sci. U.S.A.

538

253

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“…Values of serum DHEA(S) and gender demonstrated no significant contribution that accounted for prediction of responsiveness to antipsychotic treatment in schizophrenia patients. In light of the gender differences in concentrations of both DHEA(S) hormones (Carlstrom et al, 1988) future studies should include many more women in the study sample.…”

Section: Commentmentioning

confidence: 99%

Cortisol/Dehydroepiandrosterone Ratio and Responses to Antipsychotic Treatment in Schizophrenia

Ritsner

Gibel

Maayan

et al. 2005

Neuropsychopharmacol

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Dehydroepiandrosterone (DHEA) or their sulfate conjugate (DHEAS) (together abbreviated DHEA(S)) exert multiple effects in the central nervous system, and may be involved in the pathophysiological processes in schizophrenia. This prospective study aimed to investigate whether serum cortisol/DHEA(S) molar ratios are associated with response to antipsychotic treatment during the exacerbation of schizophrenia. Serum DHEA(S) and cortisol were determined at baseline, and 2 and 4 weeks later for 43 medicated schizophrenia inpatients with acute exacerbation. The patients were treated with stable doses of antipsychotic agents up to 2 weeks prior to entering the study and for the 4-week duration of the study after which they were classified as either responders or nonresponders to treatment. Findings suggest that responders had significantly higher serum cortisol levels and cortisol/DHEA(S) ratios compared with nonresponders. These differences remained significant at three time points controlling for gender, age, severity of symptoms and emotional distress, benzodiazepines, type or dosage of antipsychotic agents, and background variables. The logistic regression model shows advantages of both cortisol/DHEA(S) molar ratios vs serum cortisol and DHEA(S) concentrations for prediction of responsivity to antipsychotic treatment. No significant canonical correlations were observed between changes from baseline through end-of-study in hormonal values and severity of symptoms and emotional distress among responders and nonresponders. Thus, these data provide evidence that elevated serum cortisol and cortisol/DHEA(S) ratios may serve as markers of biological mechanisms that are involved in responsivity of schizophrenia patients to antipsychotic treatment.

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“…However, the physiological significance of this conversion to potent sex hormones is still not understood, even though it may be important pathologically. A remarkable feature of DHEAS levels in both men and women is their decrease with age, as indicated by several crosssectional studies; after maximum levels are reached during the 3rd decade of life, there is a progressive decline with age so that DHEAS levels remain 20% or less of the maximum concentration in the serum, after 70 years of age (6)(7)(8)(9)(10)(11)(12)(13)(14). The progressive decline of DHEA(S) ʈ is not the only hormonal decrease and, in particular, while the serum cortisol concentration is maintained there is most often a profound decrease of serum growth hormone and insulin-like growth factor 1 (IGF-1).…”

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confidence: 99%

Relationships of dehydroepiandrosterone sulfate in the elderly with functional, psychological, and mental status, and short-term mortality: A French community-based study

Berr

Lafont

Debuire

et al. 1996

Proc. Natl. Acad. Sci. U.S.A.

258

128

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In human beings of both sexes, dehydroepiandrosterone sulfate (DHEAS) circulating in blood is mostly an adrenally secreted steroid whose serum concentration (in the micromolar range and 30-50% higher in men than in women) decreases with age, toward Ϸ20-10% of its value in young adults during the 8th and 9th decades. The mechanism of action of DHEA and DHEAS is poorly known and may include partial transformation into sex steroids, increase of bioavailable insulin-like growth factor I, and effects on neurotransmitter receptors. Whether there is a cause-to-effect relationship between the decreasing levels of DHEAS with age and physiological and pathological manifestations of aging is still undecided, but this is of obvious theoretical and practical interest in view of the easy restoration by DHEA administration. Here we report on 622 subjects over 65 years of age, studied for the 4 years since DHEAS baseline values had been obtained, in the frame of the PAQUID program, analyzing the functional, psychological, and mental status of a communitybased population in the south-west of France. We confirm the continuing decrease of DHEAS serum concentration with age, more in men than in women, even if men retain higher levels. Significantly lower values of baseline DHEAS were recorded in women in cases of functional limitation (Instrumental Activities of Daily Living), confinement, dyspnea, depressive symptomatology, poor subjective perception of health and life satisfaction, and usage of various medications. In men, there was a trend for the same correlations, even though not statistically significant in most categories. No differences in DHEAS levels were found in cases of incident dementia in the following 4 years. In men (but not in women), lower DHEAS was significantly associated with increased short-term mortality at 2 and 4 years after baseline measurement. These results, statistically established by taking into account corrections for age, sex, and health indicators, suggest the need for further careful trials of the administration of replacement doses of DHEA in aging humans. Indeed, the first noted results of such ''treatment'' are consistent with correlations observed here between functional and psychological status and endogenous steroid serum concentrations.

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Dehydroepiandrosterone sulphate and dehydroepiandrosterone in serum: differences related to age and sex

Cited by 98 publications

References 26 publications

Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue

Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue

Cortisol/Dehydroepiandrosterone Ratio and Responses to Antipsychotic Treatment in Schizophrenia

Relationships of dehydroepiandrosterone sulfate in the elderly with functional, psychological, and mental status, and short-term mortality: A French community-based study

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