November, 2004

ST. LOUIS--Dehydroepiandrosterone (DHEA) administration was shown in animal studies to have the ability to reduce abdominal fat accumulation and protect against insulin resistance, but scientists from Washington University have now established DHEA's possible efficacy in decreasing these levels in humans.

The scientists examined the possibilities of DHEA replacement therapy and its ability to decrease abdominal fat and improve insulin action in 56 men and women aged 65 to 78 years with age-related decrease in DHEA level. In the randomized, double blind, placebo-controlled trial conducted from 2001 to 2004, participants were randomly assigned to receive 50 mg/d of DHEA or matching placebo for six months. Any change in visceral and subcutaneous abdominal fat was measured by magnetic resonance imaging (MRI) and glucose and insulin responses to an oral glucose tolerance test (OGTT).

Of the 56 men and women enrolled, 52 underwent follow-up evaluations. Compliance with the intervention was 97 percent in the DHEA group and 95 percent in the placebo group. Based on intention-to-treat analyses, DHEA therapy compared with placebo induced significant decreases in visceral fat area (–13 cm2 versus +3 cm2, respectively) and subcutaneous fat (–13 cm2 versus +2 cm2). The insulin area under the curve (AUC) during the OGTT was significantly reduced after six months of DHEA therapy compared with placebo. Despite the lower insulin levels, the glucose AUC was unchanged, resulting in a significant increase in an insulin sensitivity index in response to DHEA compared with placebo.

The scientists concluded DHEA replacement could play a role in the prevention and treatment of the metabolic syndrome associated with abdominal obesity. The study is published in the Nov. 10 issue of The Journal of the American Medical Association (292, 18:2243-2248, 2004) (http://jama.ama-assn.org).