Metabolic and Hormonal Effects of Oral DHEA in Premenopausal Women with HIV Infection: A Randomized, Prospective, Placebo-controlled Pilot Study

Abstract

Context Patients with HIV infection, both men and women, sometimes use dehydroepiandrosterone (DHEA) because of its reputation as a “youth hormone” which can improve mood and energy level. DHEA can be obtained without a prescription. However, endocrine effects of DHEA in HIV- infected individuals are poorly understood. We recently reported the endocrine effects of DHEA in HIV-infected men. We now present the results of a randomized placebo controlled double-blind study of endocrine effects of DHEA in HIV-infected women. Objective our aim was to explore the effects of DHEA on the hypothalamic-pituitary-adrenal (HPA) axis, sex steroids, circulating insulin, adiponectin, IGF-I, IGFBP-1 and IGFBP-3 in HIV infected premenopausal females. Subjects and Methods We conducted an 8-week randomized placebo controlled pilot trial of DHEA in HIV positive men and women with non-major depression. Increasing doses (100–400mg/day) of oral DHEA were administered. One hundred forty-five patients (122 men and 23 women) were randomized to receive either DHEA or placebo. 133 patients, including all 23 women, completed the trial. Of these women, 15 agreed to participate in the endocrine sub-study, conducted at the Weill Cornell GCRC. Of these, nine women were randomized to receive oral DHEA and six to placebo. Low (1mcg) dose ACTH, CRF and GnRH stimulation tests were performed in each subject before and after 8 weeks of treatment with DHEA or placebo. DHEA, DHT, total testosterone, free testosterone, sex hormone binding globulin, estrone, estradiol, cortisol, insulin, IGF-1, IGFBP-1, IGFBP-3 and adiponectin in plasma or serum were measured before and after 8 weeks of treatment with DHEA or placebo. Wilcoxon Signed Rank and the Mann Whitney tests were used to analyze the data. Results There was a significant increase in mean DHEA-S concentration (ELISA assay) (from 95+/−88 ng/ml before the study to 1138+/−849 ng/ml at week 8 of treatment, p<0.008) in the DHEA group, but not in the placebo group. There was a significant increase in the mean total testosterone concentration (0.21+/−0.1 vs. 0.76+/−0.6 ng/ml, p<0.008) and dihydrotestosterone (DHT) concentration (142.9+/−67 vs. 907.2+/−523 ng/ml, p<0.004) in the DHEA group but not in the placebo group. In addition, there was a significant increase in the estrone concentration in the DHEA group (144.3+/−83 vs 309.6+/−142 pg/ml, p<0.03) but not in the placebo group. There was a significant increase in the mean plasma concentrations of DHEA-S (p<0.032), DHEA (p<0.0006), total testosterone (p<0.01) and dihydrotestosterone (p<0.005) in the DHEA group when compared to the placebo group. There was no change in the cortisol concentration, fasting serum insulin, sex hormone binding globulin, free testosterone, estradiol, adiponectin, IGF-1, IGFBP-1 or IGFBP-3 concentrations, or ACTH, CRF or GnRH test results from week 1 to week 8 in either the DHEA or placebo groups. Conclusion We conclude that oral DHEA administration results in a significant increase in circulating DHEA-S, testosterone, DH...

Effects of IM28 on HIV-1 and Metabolic Disorders-induced Highly Active Antiretroviral Therapy in Gabonese Patients

“…The striking findings in our study are (1) IM28, the analog of DHEA is well tolerated and safety for patients; (2) IM28 affects the size of HIV reservoir in vivo; (3) IM28 affects opportunistic cardiovascular diseases-induced HAART therapy and finally (4) IM28 ameliorates mood and quality of life in HAART-treated patients like it analog DHEA as previously described (Ferrando and Freyberg, 2008b;Carrico and Antoni, 2008;Poretsky et al, 2009).…”

“…Another interesting approach was proposed by the supplementation with alpha-lipoic acid, a potent antioxidant that had positively impact patients with HIV and acquired immune deficiency syndrome by restoring blood total glutathione level and improving functional reactivity of lymphocytes to T-cell mitogens, but without any impact on body lipid (Jariwalla et al, 2008). In the same way, the widely use of dehydroepiandrosterone (DHEA) as complementary therapy among people with HIV infection has shown J Antivir Antiretrovir Volume 1(2): 076-081 (2009) -077 ISSN:1948-5964 JAA, an open access journal beneficial effects in depressive HIV1 patients (Ferrando and Freyberg, 2008a;Carrico and Antoni, 2008), particularly in women, in which DHEA provided positive potential effects on mood and energy (Davis et al, 2008;Poretsky et al, 2009). Indeed, DHEA has provided increase of AZT uptake by changing the affinity of AZT orphan transporter (Nishimura et al, 2008), appears to stimulate a significant immune response in elderly (May et al, 1990;Khorram et al, 1997) and to alter body composition by increasing lean body mass (Nestler et al, 1988;Morales et al, 1998).…”

Effects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: A systematic review and meta‐analysis of randomised clinical trials

“…We deleted 1930 duplicates, then 3283 articles were eliminated according to the title and abstract of the trials. In the next stage, 217 trials based on the full text were surveyed and lastly 14 articles with 10 arms on cortisol, [22][23][24][25][26][27][28][29][30] 5 articles with 6 arms on adiponectin, 9,27,28,31,32 2 articles with 3 arms on leptin, 9,31 2 articles with 3 arms on AST 9,32 and 4 articles with 5 arms on ALT 12,[32][33][34] (Figure 1). Table 1 lists the characteristics of 14 included articles.…”

Antihyperlipidemic Effect of Solanum incanum on Alloxan Induced Diabetic Wistar Albino Rats

“…The spectrophotometer was zeroed with the blank reagent at 520 nm. Absorbance of all tubes were read and recorded [90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105]. The procedure invqlves hydrolysis of TAG by lipase.…”