Is DHEA Replacement Therapy Beneficial?

DHEA 替代疗法有益吗？

• 批准号: 6656229
• 负责人: JOHN O. HOLLOSZY
• 金额: $ 51.29万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-15 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6656229
• 关键词: bioenergetics; blood chemistry; cardiovascular disorder risk; chemoprevention; clinical research; clinical trials; dehydroepiandrosterone; disease /disorder prevention /control; electrocardiography; enzyme linked immunosorbent assay; hormone therapy; human old age (65+); human subject; human therapy evaluation; inflammation; lipid metabolism; longitudinal human study; magnetic resonance imaging; mass spectrometry; muscle strength; noninsulin dependent diabetes mellitus; patient oriented research; quality of life; triglycerides; urinalysis; vasodilation

DESCRIPTION (provided by applicant): The major emphasis of our research on the prevention of physical frailty and loss of independence has been on the adaptations to exercise. However, because most Americans are not motivated to exercise, we have started to evaluate other approaches to maintenance of health and prevention of frailty. Of these, the most powerful appears to be DHEA replacement therapy. In this context, the overall goals of this study are to determine whether long term dehydroepiandrosterone (DHEA) replacement therapy has beneficial effects that could (a) delay the development of frailty and disability, (b) protect against development of type 2 diabetes and coronary artery disease, (c) improve quality of life, and d) obtain information on the mechanisms of DHEA action. DHEA and DHEA sulfate (DHEAS) plasma concentrations peak at about 20 yr of age and decline rapidly and markedly after age 25 yr. DHEA is a PPAR-alpha activator. PPAR-alpha plays major roles in regulating lipid metabolism and controlling inflammation. DHEA also appears to have anabolic effects on muscle and bone. The study proposed here is a randomized, double blind, placebo-controlled trial of DHEA replacement. It is designed to determine the effects of 12 mo of DHEA replacement in 65-75 yr old women and men on (a) truncal and visceral fat, (b) insulin resistance and serum triglycerides, (C) muscle mass and strength, (d) bone mineral density, (e) chronic inflammation, (f) arterial-endothelium-dependent vasodilation, and (g) sense of well being. The specific aims of this study are to test the hypotheses that 12 mo of DHEA replacement will (a) Result in significant decreases in truncal and visceral fat by shifting metabolism to fat oxidation and increasing energy wastage; (b) Decrease insulin resistance and decrease serum triglycerides; (c) Increase muscle mass and strength, by decreasing catabolic stimuli and increasing anabolic stimuli; (d) Increase bone mineral density by increasing anabolic stimuli and decreasing catabolic stimuli; (e) Reduce chronic inflammation and decrease pro-inflammatory cytokine production by peripheral blood mononuclear cells; (f) Improve arterial endothelium dependent vasodilation; and (g) Improve general sense of well being. A major emphasis of this research is on the mechanisms responsible for the biological effects of DHEA replacement.

描述（由申请人提供）：我们研究的主要重点是预防身体脆弱和失去独立性，这是对运动的改编。但是，由于大多数美国人没有动力运动，因此我们已经开始评估其他维持健康和预防脆弱的方法。其中，最强大的似乎是DHEA替代疗法。在这种情况下，这项研究的总体目标是确定长期脱氢表甲酮（DHEA）替代疗法是否具有有益的效果，可以（a）延迟脆弱和残疾的发展，（b）防止2型糖尿病和冠状动脉疾病的发展，（c）改善生命的质量，D）提高了Dhea的机构的信息。 DHEA和DHEA硫酸盐（DHEAS）血浆浓度在约20岁的年龄峰值峰值，并在25岁之后迅速下降。 DHEA是PPAR-Alpha激活剂。 PPAR-α在调节脂质代谢和控制炎症方面起着重要作用。 DHEA似乎对肌肉和骨骼也具有合成代谢作用。此处提出的研究是一项随机，双盲，安慰剂对照的DHEA替代试验。它旨在确定65-75岁的老年男女在（a）（a）截短和内脏脂肪中的12 mo替代物的影响，（b）胰岛素抵抗和血清甘油三酸酯，（c）肌肉质量和力量，（d）骨骼矿物质密度，（e）慢性炎症，（f）Arterip-Endotherium interentent interentent intedent intedent intedent intedent intertant and intedent intedent intedent intedent inteptation，and依赖性vasod，（g）。这项研究的具体目的是测试12个月DHEA替代物的假设（a）通过将代谢转移到脂肪氧化并增加能量浪费来导致截短和内脏脂肪的显着降低； （b）降低胰岛素抵抗并降低血清甘油三酸酯； （c）通过减少分解代谢刺激并增加合成代谢刺激来增加肌肉质量和力量； （d）通过增加代谢刺激并减少分解代谢刺激来增加骨矿物质密度； （e）减少慢性炎症并减少外周血单核细胞产生促炎的细胞因子； （f）改善动脉内皮依赖性血管舒张； （g）提高一般的福祉感。这项研究的主要重点是负责DHEA替代生物学作用的机制。