Anorexia, Bone Growth, and Low DHEA (Harvard Med)

James Howard jmhoward at sprynet.com
Wed Jan 20 07:46:54 EST 1999


J Bone Miner Res 1999 Jan;14(1):136-145

“Changes in Bone Turnover Markers and Menstrual Function After Short-term
Oral DHEA in Young Women with Anorexia Nervosa”

Gordon CM, Grace E, Jean Emans S, Goodman E, Crawford MH, Leboff MS
Division of Adolescent/Young Adult Medicine, Children's Hospital, Harvard
Medical School, Boston, Massachusetts.; Division of Endocrinology,
Children's, Hospital, Department of Pediatrics, Harvard Medical School,
Boston, Massachusetts.

“Bone loss is a serious consequence of anorexia nervosa (AN). Subnormal
levels of serum dehydroepiandrosterone (DHEA) are seen in patients with AN
and may be causally linked to their low bone density. We hypothesized that
oral DHEA would decrease markers of bone resorption (urinary N-telopeptides
[NTx]), and increase markers of bone formation (serum bone-specific alkaline
phosphatase and osteocalcin [OC]). Fifteen young women (age 15-22 years)
with AN were enrolled in a 3-month, randomized, double-blinded trial of 50,
100, or 200 mg of daily micronized DHEA. Blood and urinary levels of adrenal
and gonadal steroids and bone turnover markers were measured. No adverse
clinical side effects of DHEA were noted, and a 50 mg daily dose restored
physiologic hormonal levels. At 3 months, NTx levels had decreased
significantly in both the 50 mg (p = 0.018) and the 200 mg (p = 0.016)
subgroups. OC levels simultaneously increased within treatment groups over
time (p = 0.002). Eight out of 15 (53%) subjects had at least one menstrual
cycle while on therapy. Short-term DHEA was well-tolerated and appears to
normalize bone turnover in young women with AN. Resumption of menses in over
half of subjects suggests that DHEA therapy may also lead to estradiol
levels sufficient to stimulate the endometrium in this group of patients.”







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