Differential Effect of Oral Dehydroepiandrosterone-Sulphate on Metabolic Syndrome Features in Pre- and Postmenopausal Obese Women

Cecilia Gómez-Santos; Juan José Hernández-Morante; Francisco Javier Tébar; Esteban Granero; Marta Garaulet

Disclosures

Clin Endocrinol. 2012;77(4):548-554. 

In This Article

Results

General Baseline Characteristics

Baseline population characteristics are shown in Table 1. There were no significant differences in any of the analyzed baseline parameters between the placebo and treated group, which makes the interpretation of the effect of DHEA-S treatment more reliable.

As regards the different MetS features, our data showed that the clinical baseline characteristics of all groups were closer to the upper limits described in the IDF definition. As expected, younger patients (premenopausal women) had higher levels of DHEA-S and showed a better metabolic profile (Table 1). The HOMA index was high in both groups of treated women,[24] and so this population can be described as insulin resistant.

Effect of DHEA-S Treatment in Postmenopausal Women (Placebo vs Treated Group)

Table 2 summarizes the different anthropometric and biochemical changes after 3 months of treatment in both placebo and treated groups of postmenopausal women. There were no significant changes in anthropometric, glucose or lipid metabolism parameters in the placebo group. However, in the treated group, oral DHEA-S exerted a significant effect on MetS features, waist circumference and both systolic and diastolic blood pressure decreasing significantly. Our data also revealed a marked reduction in fasting plasma glucose levels and the HOMA index (insulin resistance decreased to normal HOMA levels). Fasting plasma insulin also decreased, but not significantly. Additionally, there was a significant decrease in the anthropometric characteristics not included in the MetS definition, such as body mass index (BMI), body weight, body fat percentage and hip circumference, which demonstrated the effectiveness of DHEA-S in weight loss.

With regard to the lipid metabolism parameters, only total plasma cholesterol decreased significantly. Triglycerides were reduced, but not to a statistically significant extent, whereas LDL- and HDL-cholesterol were apparently unaffected by DHEA-S treatment. To confirm these data, a general linear model test between placebo vs treated women was performed. Data were consistent, except for total cholesterol and the HOMA index, in both of which significance was lost (P inter Table 2).

Moreover, adiponectin, leptin and ghrelin were significantly lower as a consequence of the DHEA-S replacement therapy, as was revealed by a paired t-test. Nevertheless, significance was also lost after more strict statistical analysis (P inter Table 2).

Effect of DHEA-S Treatment Depending on the Menopausal Status (Postmenopausal vs Premenopausal Treated Groups)

Table 3 represents different MetS features and other parameters before and after three months of treatment in pre- and postmenopausal women. As expected, significant differences between pre- and postmenopausal women were observed in several basal MetS features (P group).

Interestingly, our data indicate that treatment with DHEA-S improved all obesity parameters in both groups, whereas MetS parameters were significantly improved only in postmenopausal women (Table 3). Moreover, there was an interaction between the group of women studied (pre- and postmenopausal) and the effect of treatment (initial and final) for blood pressure (which decreased only in postmenopausal women), and adiponectin and ghrelin, for which DHEA-S exerted an opposite effect in pre- and postmenopausal women (P inter).

If we focus our attention in the premenopausal women, the data indicated that several obesity parameters (weight, BMI, body fat and leptin) decreased significantly with treatment (Table 3), while no significant changes were observed in any of the MetS components.

Effects of DHEA-S on Total MetS Score

Figure 1 represents the effect of DHEA-S treatment on MetS (score) in the three groups studied, placebo, and pre- and postmenopausal women. A significant decrease in the MetS score as a consequence of DHEA-S treatment was only observed in postmenopausal women, and no significant changes were found in premenopausal or placebo women.

Figure 1.

Effect of, dehydroepiandrosterone-sulphate treatment in the three groups studied (placebo, prepostmenopausal women), in Metabolic syndrome, Metabolic syndrome (Score). Mean ± SEM. Differences between initial (filled square) and final (empty square) samples were tested with a paired Student's t-test. Single asterisk represents statistical significant differences, P < 0·05.

processing....