Effects of Dehydroepiandrosterone and Atamestane Supplementation on Frailty in Elderly Men
Open accessAbstract
Background: It has been suggested that the age-related decline of androgens in men plays a distinct role in the development of several aspects of frailty. Therefore, hormone replacement might improve the course of frailty by increasing lean body mass and muscle strength, decreasing fat mass, and improving the subjective quality of life. Objective: The objective of the study was to assess whether hormone replacement with dehydroepiandrosterone (DHEA) and/or atamestane might improve the course of frailty. Design: This was a double-blind, randomized, controlled trial. Setting: The study was conducted in the general community. Participants: Participants included 100 nonhospitalized, nondiseased, independently living men, aged 70 yr and over with low scores on strength tests. Seventeen participants did not complete the trial. Intervention: Subjects were randomly assigned to one of four intervention arms: atamestane (100 mg/d) and placebo, DHEA (50 mg/d) and placebo, a combination of atamestane (100 mg/d) and DHEA (50 mg/d), or two placebo tablets for 36 wk. Main Outcome Measures: Physical frailty was measured by means of a specific test battery, including isometric grip strength, leg extensor power, and physical performance. Results: The randomization was successful, and 83 (83%) men completed the intervention. There were no differences between the treatment arms and placebo group in any of the outcome measurements after intervention. Conclusions: The results of this double-blind, randomized trial do not support the hypothesis that hormone replacement with DHEA and/or atamestane might improve the course of frailty.
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When testicular testosterone and estradiol synthesis are suppressed and testosterone is administered exogenously in combination with letrozole, the estradiol/testosterone ratio is suppressed by 81%.
“When testicular testosterone and estradiol synthesis are suppressed and testosterone is administered exogenously in combination with letrozole, however, the estradiol/testosterone ratio is suppressed by 81% [30], which is only marginally different from the suppression of this ratio in intact men after treatment with letrozole.”
From Aromatase inhibitors in men: effects and therapeutic options (2011) · cites this paper as [30]
In experimental settings, selective withdrawal of estradiol in men was associated with an increase in markers of bone resorption.
“In experimental settings, selective withdrawal of estradiol in men was associated with an increase in markers of bone resorption [30,81].”
From Aromatase inhibitors in men: effects and therapeutic options (2011) · cites this paper as [30]
Smaller RCTs have similarly reported that despite robust increases in testosterone, AIs had no effect on a large array of psychological and somatic measures in men with age- or obesity-associated reductions in testosterone.
“Smaller RCTs have similarly reported that despite robust increases in testosterone, AIs had no effect on a large array of psychological and somatic measures in men with age-or obesity-associated reductions in testosterone.[116][117][118]”
From Hypogonadism and male obesity: Focus on unresolved questions (2018) · cites this paper as [117]
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- Authors
- Muller, M., van den Beld, A. W., van der Schouw, Y. T., Grobbee, D. E., & Lamberts, S. W. J.
- Affiliations
- University Medical Center Utrecht (NL)
- Department of Internal Medicine (A.W.v.d.B., S.W.J.L.), Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care (M.M., Y.T.v.d.S., D.E.G.) 3508 GA Utrecht, The Netherlands
- Erasmus MC (NL)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2006-10-01
- Volume
- 91
- Issue
- 10
- Pages
- 3988-3991
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1977616846
- Cited by
- 62
- References
- 23
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 3 · 2014: 4 · 2013: 2 · 2012: 3
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- dehydroepiandrosterone, hormone replacement therapy, frailty, older men, androgen deficiency, grip strength, leg extensor power, physical performance, muscle strength, lean body mass
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Androstenedione, Dehydroepiandrosterone, Double-Blind Method, Humans, Male, Testosterone, Bone Density, Frail Elderly, Hormone Replacement Therapy
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