The accumulation of abdominal fat increases with advancing age, and there is extensive evidence that abdominal obesity increases the risk for development of insulin resistance, diabetes, and atherosclerosis, according to background information in the article. Hormonal/metabolic changes that occur with aging may contribute to the increase in abdominal fat that generally occurs during middle and old age. One such change is the decline in production of the adrenal hormone dehydroepiandrosterone (DHEA). The blood level of DHEA, most of which is present in the sulfated form (DHEAS), peaks at approximately 20 years of age and declines rapidly and markedly after age 25. DHEA administration has been shown to reduce accumulation of abdominal fat and protect against insulin resistance in laboratory animals, but it was not known whether DHEA decreases abdominal obesity in humans. DHEA is widely available as a dietary supplement without a prescription.
Dennis T. Villareal, M.D., and John O. Holloszy, M.D., of Washington University School of Medicine, St. Louis, conducted a study to test the hypothesis that DHEA replacement therapy results in a decrease in abdominal fat and an improvement in insulin action in elderly persons.
The randomized, double-blind, placebo-controlled trial included 56 elderly persons (28 women and 28 men, average age, 71 [range, 65-78]) with age-related decrease in DHEA level. The study was conducted at Washington University School of Medicine from June 2001 to February 2004. Participants were randomly assigned to receive 50 mg/d of DHEA or matching placebo for 6 months.
The researchers found that DHEA replacement therapy induced significant decreases in both visceral fat (within the
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