A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults

Abstract

To find out if DHEA replacement improves bone mineral density (BMD) in healthy older adults. We systematically searched Medline via PubMed, Embase, and the Cochrane Library Center Register to identify randomized controlled trials up to October 2018. Effect estimates were performed in random effect models. Bone mineral density of hip and trochanter, total body, lumbar spine, and femoral neck were conducted. Hip BMD increased significantly above placebo group in women who took DHEA supplementation (SMD –0.5[–0.95, –0.04], p = .03). The SMD of trochanter BMD of women in placebo group than DHEA group was –0.55 [–1.10, 0.00], p = .05. Insulin-like growth factor 1 (IGF-1) did not change in men compared to placebo group also (–0.56 [–1.22, 0.10], p = .09). In women, IGF-1 significantly improved in DHEA supplementation group than placebo group (–2.61 [–4.85, –0.38], p = .02). In summary, the results of this meta-analysis suggest that DHEA replacement therapy can partially increase BMD of hip and trochanter in women. Similar results were not observed in men. More trials may be necessary to allow for a positive and clinically significant effect of DHEA on BMD.

摘要

了解脱氢表雄酮(DHEA)替代疗法是否能改善健康老年人的骨密度(BMD)。我们通过对PubMed、荷兰医学文摘数据库和科克伦图书馆中心注册系统进行系统的医学检索, 以确定随机对照试验, 截止时间为2018年10月。在随机效应模型中进行效果估计。测量髋部和大转子、全身、腰椎和股骨颈的骨密度。在服用DHEA补充剂的妇女中, 髋部BMD明显高于安慰剂组(SMD-0.5[-0.95, -0.04], p=0.03)。安慰剂组与DHEA组大转子BMD的SMD为-0.55[-1.10, 0.00], P=0.05。与安慰剂组相比, 男性胰岛素样生长因子1(IGF-1)也未发生变化(-0.56[-1.22, 0.10], p=0.09)。在女性中, DHEA补充组的IGF-1比安慰剂组明显改善(-2.61[-4.85, -0.38], p=0.02)。总之, 这一荟萃分析的结果表明, DHEA替代疗法可以部分增加女性髋部和大转子的BMD。在男性中没有观察到类似的结果。为了观察DHEA对BMD产生积极的临床显著影响, 可能需要进行更多的试验。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• DHEA
• dehydroepiandrosterone
• bone mineral density
• BMD
• meta-analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors received funding from the National Natural Science Foundation of China (ID: 81871211).