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Meta-analysis: DHEA supplementation may reduce fat mass in elderly men
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Recent data suggest dehydroepiandrosterone supplementation in elderly men could induce a regulation of fat mass distribution.
According to a study conducted by Giovanni Corona, MD, PhD, of the endocrinology unit at Azienda USL Bologna, Maggiore-Bellaria Hospital, in Bologna, Italy, and colleagues, the current data on the use of dehydroepiandrosterone (DHEA) supplementation in men with primary adrenal insufficiency are lacking.
To assess the effects of DHEA in elderly men, Corona and colleagues analyzed 25 of 220 randomized, controlled trials that included 1,353 men with a mean follow-up of 36 weeks.
Data indicate DHEA supplementation was associated with fat mass reduction, with a standardized mean difference of –0.35 (95% CI, –0.65 to –0.05) and a trend toward an increase in lean mass.
However, Corona and colleagues wrote that the association disappeared after adjustments for DHEA-related metabolite increases such as total testosterone and estradiol.
Conversely, compared with placebo, there were no associations between DHEA supplementation and other clinical parameters like lipid and glycemic metabolism, bone health, sexual function and quality of life.
“Data derived from the present meta-analysis show that DHEA supplementation exerts some positive effects on body composition, in particular reducing fat mass. However, multivariate analysis of the data suggests that this effect could be related more to a variation in circulating levels of total testosterone and estradiol increase than to DHEA itself,” the researchers wrote. “The data should be interpreted with caution, as they could be the effect of ecological fallacy.”
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Ronald Tamler, MD, PhD, MBA
American men are engaged in a large-scale, mostly unsupervised experiment. Many are taking over-the-counter DHEA, purchased online, from drug stores, groceries or even bodegas. Medical conditions such as diabetes, obesity or osteoporosis are associated with declining levels of DHEA and its sulfate DHEAS. Above all, one particularly hard-to-cure condition drives men to self-medicate: aging.
An Italian group sought to bring clarity by providing a meta-analysis of randomized, placebo-controlled studies in elderly men, published online in July in the Journal of Clinical Endocrinology and Metabolism. Tellingly, only 25 out of 220 retrieved articles qualified, with 1,353 patients. While initial analysis found a small but significant decrease in fat mass compared with placebo, that difference disappeared after adjustment for DHEA metabolites, testosterone and estradiol. There was no difference in markers pertaining to glycemia, lipids, bone health, sexual function or quality of life.
The upshot for our patients in general is DHEA is not the fountain of youth, although certain subpopulations may still stand to benefit.
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