Low levels of dehydroepiandrosterone sulfate are associated with the risk of developing cardiac autonomic dysfunction in elderly subjects

ABSTRACT Objective: To assess the relationships between serum dehydroepiandrosterone sulfate (DHEA-S) levels and heart rate variability (HRV) among different age groups. Subjects and methods: Forty-five healthy men were divided into 3 groups: young age (YA; 20-39 yrs; n = 15), middle age (MA; 40-59 yrs; n = 15) and old age (OA; ≥ 60 yrs; n = 15). Hemodynamic parameters, linear analyses of HRV and concentrations of cortisol and DHEA-S were measured at rest. Results: The OA group presented a higher resting heart rate (84.3 ± 4.6 bpm) than the YA group (72.0 ± 4.4 bpm; p < 0.05). The YA group showed an attenuated variance of HRV (2235.1 ± 417.9 ms2) compared to the MA (1014.3 ± 265.2 ms2; p < 0.05) and OA (896.3 ± 274.1 ms2; p < 0.05) groups, respectively. The parasympathetic modulation of HRV was lower in both the MA (244.2 ± 58.0 ms2) and OA (172.8 ± 37.9 ms2) groups in comparison with the YA group (996.0 ± 255.4 ms2; p < 0.05), while serum DHEA-S levels were significantly lower in both the MA (91.2 ± 19.6 mg/dL) and OA (54.2 ± 17.7 mg/dL) groups compared to the YA group (240.0 ± 50.8 mg/dL; p < 0.05). A positive correlation between lower serum concentrations of DHEA-S and attenuated variance of HRV (r = 0.47, p = 0.031), as well as lower serum concentrations of DHEA-S and decreased parasympathetic modulation of HRV (r = 0.54, p = 0.010), were found. Conclusion: The present study demonstrated that the decline of plasma DHEA-S is associated with reduced cardiac autonomic modulation during the aging process.

Assessing endocrine and immune parameters in human immunodeficiency virus-infected patients before and after the immune reconstitution inflammatory syndrome

ABSTRACT Objective The present study compares immune and endocrine parameters between HIV-infected patients who underwent the Immune Reconstitution Inflammatory Syndrome (IRIS-P) during antiretroviral therapy (ART) and HIV-patients who did not undergo the syndrome (non-IRIS-P). Materials and methods Blood samples were obtained from 31 HIV-infected patients (15 IRIS-P and 16 non-IRIS-P) before ART (BT) and 48 ± 2 weeks after treatment initiation (AT). Plasma Interleukin-6 (IL-6) and Interleukin-18 (IL-18) were determined by ELISA. Cortisol, dehydroepiandrosterone sulfate (DHEA-S) and thyroxin concentrations were measured using chemiluminescence immune methods. Results Concentrations of IL-6 (7.9 ± 1.9 pg/mL) and IL-18 (951.5 ± 233.0 pg/mL) were significantly higher (p < 0.05) in IRIS-P than in non-IRIS-P (3.9 ± 1.0 pg/mL and 461.0 ± 84.4 pg/mL, respectively) BT. Mean T4 plasma level significantly decreased in both groups of patients after treatment (p < 0.05). In both groups cortisol levels were similar before and after ART (p > 0.05). Levels of DHEA-S in IRIS-P decreased AT (1080.5 ± 124.2 vs. 782.5 ± 123.8 ng/mL, p < 0.05) and they were significantly lower than in non-IRIS-P (782.5 ± 123.8 vs. 1203.7 ± 144.0 ng/mL, p < 0.05). IRIS-P showed higher values of IL-6 and IL-18 BT and lower levels of DHEA-S AT than in non-IRIS-P. Conclusion These parameters could contribute to differentiate IRIS-P from non-IRIS-P. The significant decrease in DHEA-S levels in IRIS-P after ART might suggest a different adrenal response in these patients, which may reflect the severity of the disease.

Study of Estradiol, Testosterone and DHEA-S Status in Women After Surgical Menopause.

Aims and Objectives : The study was done to assess the hormones namely Estradiol, Testosterone, and Dehydroepiandrosterone-sulphate (DHEAs) one day before operation and on ninth post-operative day following surgical menopause. Materials and Methods : This is a cross sectional observational study. The study was done amongst the thirty four women aged between 40-48 years with functioning uterus and at least one ovary, not using any exogenous hormone preparations affecting ovarian function for last three months and having at least one menstrual period in three previous months were included in this study. They had under gone hysterectomy with bilateral salpingooophorectomy due to non-ovarian pathology. Fasting venous blood samples were taken one day before operation and on ninth post-operative day of surgical menopause Serum concentration of estradiol, testosterone, and DHEAS were determined. Results : The circulating estradiol level decreased significantly (p = 0.043) from 161 pg/ml preoperatively to 108 pg/ml. on ninth post-operative day after surgical menopause. In spite of reduction in mean testosterone level from 0.11 ng/ml. to 0.09 ng/ml. following surgical menopause, which is statistically insignificant (p = 0.247).There was no significant difference between the serum DHEA-S level before and after surgical menopause. A significant positive correlation was observed between pre-operative circulatory levels of DHEA-S with that of estradiol while there was absence of any significant co-relations corelations between any of the other pairs of values. Conclusion : The circulating estradiol level decreased significantly on ninth day after surgical menopause and significant positive correlation between pre-operative circulatory levels of DHEA-S with that of estradiol, but there was no significant co-relation between post-operative circulating estradiol with that of DHEA-S. Testosterone did not show any significant relation with estradiol neither in pre-operative period nor in post-operative condition.

Effects of heat stress on endocrine functions & behaviour in the pre-pubertal rat.

Background & objectives: Heat stress related hyperthermia may cause damage to various organ systems. There are very few studies on the effects of hyperthermia on the endocrine system. We therefore, investigated effects of exogenously induced hyperthermia on adrenal, testicular and thyroid functions and behavioural alterations in pre-pubertal male Sprague-Dawley rats. Methods: Three groups of 30-day old rats (n=7 per group) were used. Body temperature was increased to 39°C (Group I) and 41°C (Group II) in a hyperthermia induction chamber for 30 min. The rats in the Group III served as control (36 °C). All animals received saline and were decapitated 48 h after the experiments. Serum free triiodothyronin (fT3), free thyroxine (fT4), total testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were determined by chemiluminescence assay, and corticosterone by enzyme immunoassay. Testes, pituitary and adrenal glands were dissected out and processed for histopathological examination. To assess activity and anxiety of the animals, the open field test and elevated-0-maze test, respectively, were used in all groups 24 h before (day 29) and after (day 31) hyperthermia induction. Results: Serum corticosterone levels (3.22±1.3) were significantly reduced in the 39°C (1.3±0.9) and 41°C (1.09±0.7) hyperthermia groups (P<0.01) compared to controls. Serum levels of thyroid hormones did not significantly differ among the groups. DHEA-S and testosterone values were below the limit of detection in all groups. Histopathological examination revealed that there was mild hydropic degeneration in the pituitary and adrenal glands. Apoptotic germ cells were seen in the seminiferous tubules of pre-pubertal male rats exposed to hyperthermia (41°C). Progression time in the open field test was significantly decreased and anxiety test scores increased in animals exposed to 39°C compared to the control group (P<0.01). These parameters were more pronounced in the 41°C hyperthermia group. Interpretation & conclusions: Our results show that heat exposure-induced stress may cause delayed reduction in serum corticosterone levels which may be associated with behavioural deficits in pre-pubertal male rats.

Metformin therapy decreases hyperandrogenism and ovarian volume in women with polycystic ovary syndrome

It is well known that there is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy in polycystic ovary syndrome [PCOS]. The objective of this study was to investigate the effects metformin on the hyperandrogenism and ovarian volume in PCOS. The study is an unrandomized clinical trial with before-after design. Twenty eight patients with infertility [male or female factor] meeting the Rotterdam ESHRE/ASRM criteria for PCOS were studied during the 2008-2009. The anthropometric characteristics of the patients, mean bilateral ovarian volume, and morphology by trans vaginal sonography as well as the plasma levels of leutinizing hormone, follicle stimulating hormone, estradiol, testosterone, 17- alpha -hydroxyprogesterone, and dehydroepianderosterone sulfate were obtained before and after treatment with metformin [500 mg three times a day] for three months. Paired t, Pearson's Correlation Coefficient, or Partial Correlation test was used to analyze the findings. The patients had a mean age of 25.67 years. A significant reduction in mean ovarian volume [11.70 +/- 4.31 ml vs 8.27 +/- 3.71 ml P=0.001], body mass index [BMI, 28.11 +/- 4.55 kg/m[2] vs 26.84 +/- 4.55 kg/m[2] P=0.000] and serum androgen levels was seen after three months of treatment with metformin. There was positive correlations between the ovarian volume and serum testosterone level [r=0.589, P=0.001] or BMI [r=0.663, P=0.000]. Metformin therapy may lead to a reduction in ovarian volume. It is likely that the reduction of ovarian volume reflect a decrease in the mass of androgen producing tissues

Relationship between dhea and dhea-s with anthropometric indices in women with different grades of obesity

Dehydroepiandrosterone [DHEA] and dehydroepiandrosterone sulfate [DHEA-S] are the most abundant steroids in human plasma. The aim of this study was to evaluate the relationship between DHEA and DHEA-S and anthropometric indices in women with different grades of obesity. This cross- sectional study investigated 170 women; 35 normal weight [BMI= 18.9-24.9], 33 overweight, [BMI = 25-29.9] as 36 women [BMI= 30-34.9] as obese grade I, 33 [BMI = 35-39.9] as obese grade II and 33 [BMI>40] as obese grade III. Body mass index was defined as weight in kilograms divided by the square of the height in meters. Serum levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate and glucose were measured by commercially available enzyme immunoassay kits and the glucose oxidase method, respectively. There was a negative and significant correlation between DHEA and age in the normal [r=-0.457, P=0.006] overweight [r=-0.414, P=0.017] obese l [r=-0.402, P=0.015] obese ll [r=-0.391, P=0.024] and obese III [r=-0.354, P=0.043] groups, respectively. Also a negative and significant correlation was found between DHEA-S and age in overweight [r=-0.394, P=0.019], obese grade I [r=-0.455, P=0.005] and obese grade II [r=-0.390, P=0.023] groups respectively. We found a positive and significant correlation between DHEA and frame size in individuals of the Obese I, Obese II and Obese III groups, and also a positive and significant correlation between DHEA-S and frame sizes in individuals of these three groups. Results showed that serum levels of DHEA decrease with increasing grades of obesity, whereas serum levels of DHEA-S increase with increasing obesity

Association between androgenic hormone levels and left ventricular ejection fraction

Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this study was to compare androgenic hormone levels in patients with different left ventricular ejection fractions [EF]. The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF=35-45%, EF=45-54%, and EF >/= 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone [fT], total testosterone [tT], and dehydroepiandrosterone sulfate [DHEAS]. To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF >/= 35%. There were statistically significant trends in some characteristics in the patients with different levels of EF. The subjects with higher EF levels were less likely to have diabetes [p value < 0.001], coronary artery lesion [p value < 0.001], or high levels of C-reactive protein [CRP] [p value < 0.001]. As regards the patients with severe heart failure, our regression analysis revealed that the fT level was significantly lower in those with EF < 35% than in the ones with EF >/= 35% [5.82 +/- 2.73 pg/mL vs. 6.88 +/- 3.34 pg/mL, p value < 0.05]. A significant association was found between the level of fT and EF < 35%. There is a need for further controlled prospective studies to delineate any possible causal relationship accurately

Study of the relationship between serum cortisol and dehydroepiandrosterone sulfate [DHEAS] levels and degree of cognitive impairment in the aged with Alzheimer's disease and vascular dementia

Dementia is the general term that refers to the decline of mental abilities including memory and other thinking skills while a person is alert and awake. Dementia is considered a late-life disease because it tends to develop mostly in elderly people. The two most common forms of dementia in older people are Alzheimer's disease and multi-infarct dementia [vascular dementia]. Alzheimer's disease accounts for around 60% of all cases of dementia, while vascular dementia accounts for up to 20% of all cases of dementia. Cortisol and dehydroepiandrosterone [DHEA] and its sulfate ester [DHEAS] are adrenal steroid hormones. These hormones have been suggested to have a role in many aging related diseases and perhaps in aging itself. These hormones have been shown to multiple effects on the function of the hippocampus, which is involved in learning and memory processes. These adrenal steroids may thus be associated with cognitive impairment, which is a major symptom of dementia. To study the relationship between serum cortisol and dehydroepiandroesterone sulfate [DHEAS] levels and degree of cognitive impairment in the aged persons with Alzheimer's disease and vascular dementia. Study was conducted on 30 elderly demented patients selected randomly from the general population. Their ages ranged from 52 to 85 years with a mean of 68.5 years and they were 13 males and 17 females, they were divided into two groups; group I: 15 patients [7 males and 8 females] with probable Alzheimer's disease diagnosed according to diagnostic and statistical manual of mental disorder [DSM- IV criteria], group II: 15 patients [6 males and 9 females] with vascular dementia, group III consisted of 15 elderly healthy volunteers, matched for age and sex with no evidence of dementia have been served as control group. All were submitted to morning collection of blood for determination of the plasma cortisol and DHEAS measured by chemiilluminescence. The 30 points Mini Mental State Examination [MMSE] was used to assess cognition. The present study firstly showed that mean serum cortisol level increase while mean serum DHEAS level decrease with age and mean serum cortisol levels was higher in both AD and VD than normal controls while mean serum DHEAS levels in both AD and VD] was lower than normal controls. Gender did not play a significant role in variability of cortisol and DHEAS. Also, most of Alzheimer's disease patients were none educated in comparison to vascular dementia patients and this indicates that a low level of education has been associated with a greater risk of developing AD. There is an association between serum cortisol and DHEAS levels and severity and duration of dementia and cognitive decline in demented patients. There is a strong association between cortisol and DHEAS and prevalence of dementia in the elderly. There was a trend of high serum cortisol level in males and high serum DHEAS level in females but, gender did not play a significant role in variability of cortisol and DHEAS. Low level of education has been associated with a greater risk of developing dementia and there is association between serum cortisol and serum DHEAS levels and duration and severity of dementia

Niveles elevados de andrógenos plasmáticos en mujeres con hipertensión asociada al embarazo / High androgen plasmatic levels in women affected with pregnancy-induced hypertension

Objective. To compare the plasmatic levels of free testosterone (FT), total testosterone (TT), and dehydroepiandrosterone sulphate (DHEAs) obtained from women with pregnancy-induced hypertension (PIH) and from uncomplicated pregnant women in the third trimester of pregnancy. Methods. FT, TT and DHEAs were measured by radioimmunoassay in plasma samples from 30 women with PIH (PIH group) defined as mean blood pressure > 105 mm Hg, and proteinuria > 100 mg/dL and < 300 mg/dL, and in 30 women with uncomplicated pregnancies (control group). Gestational age at the time of the study in the PIH group was 37 weeks +2 days (28+0 - 40+1), and in the control group, 37 weeks +1 day (28+0 - 41+6). The plasmatic androgen levels and the perinatal outcome were analysed in both groups. Results. There was no difference in the gestational age at birth. In the PIH group there were increased number of caesarean sections due to fetal distress (PIH group; n = 10, control group; n = 2; p = 0.05), lower birthweight (PIH group 2549 g [800-3400 g], control group 3242 g [2400-4200 g]; p = 0.02) and increased number of neonatal intensive unit care admissions (PIH group; n = 3, control group; n = 0). In the PIH group, FT and TT levels were significantly higher than controls (mean, SD) (FT PIH group, 5.94 (0.9) pg/mL; FT control group, 0.44 (0.2) pg/mL; p = 0.002. TT PIH group, 5.28 (2.4) nmol/L; TT control group, 3.6 (0.6) nmol/L; p = 0.02. There was no difference in DHEAs levels between the groups (mean, SD) (PIH group, 51.13 (23.7) µg/dL; control group, 70.0 (13.5) /igldL). Conclusions. In women complicated with PIH there is an increment in the plasmatic levels of FT and TT. This might contribute to the clinical findings and the adverse perinatal outcome observed in this patients.

Objetivo. Comparar los valores plasmáticos de testosterona libre (TL), testosterona total (TT) y sulfato de dehidroepiandrosterona (DHEAs) entre mujeres con hipertensión asociada al embarazo (HAE) y mujeres con embarazos normales en el tercer trimestre de la gestación. Mátodos. Se midieron TL, TT y DHEAs en el plasma de 30 mujeres con diagnóstico de HAE (grupo HAE), definida como tensión arterial media > 105 mm Hg y proteínas en orina >100 mg/dL y < 300 mg/ dL, y en 30 mujeres embarazadas sin HAE (grupo control) y los valores obtenidos se compararon entre ambos grupos. La edad gestacional de las pacientes del grupo control fue lo más similar posible a las pacientes del grupo con HAE. Resultados. TL y TT resultaron significativamente más altas en el grupo con HAE (media, DS). TL grupo HAE 5.94 (0.9) pg/mL; TL grupo control 0.44 (0.2) pg/mL; p = 0.002. TT grupo HAE 5.28 (2.4) nmol/L; TT grupo control 3.6 (0.6) nmol/L; p = 0.02. No hubo diferencias significativas en los valores de DHEAs (media, DS) grupo HAE 51.13 (23.7) µg/dL; grupo control 70.0 (13.5) µg/dL. La edad gestacional al momento del estudio en el grupo HAE fue de 37 semanas + 2 días (28 + 0 -40+1) y en el grupo control de 37 semanas +1 día (28+0 - 41+6). No hubo diferencia en la edad gestacional al nacimiento. El grupo con HAE presentó un mayor número de cesáreas por indicación fetal (grupo HAE n = 10; grupo control n = 2; p = 0.05), menor peso al nacimiento (grupo HAE 2549 g [800-3400 g]; grupo control 3242 g [2400-4200 g]; p = 0.02) y mayor número de ingresos a la unidad de cuidados intensivos neonatales (grupo HAE n = 3; grupo control n = 0). Conclusiones. En embarazadas con HAE, TL y TT están elevadas, pudiendo contribuir en las manifestaciones clínicas y en el peor resultado perinatal que tienen estas pacientes.

Cortisol y dehidroepiandrosterona nocturnos como marcadores pronósticos en pacientes críticos / Nocturnal cortisol and dehydroepiandrosterone like prognostic markers in critical patients

El cortisol plasmático guarda correlación con la severidad y duración del estado crítico, y el papel de la Dehidroepiandrosterona sulfato (DHEA-S) no ha sido identificado claramente. El paciente crítico muestra una activación máxima inicial del eje suprarrenal, si la situación crítica se prolonga, se puede producir una insuficiencia suprarrenal relativa. Midiendo cortisol y DHEA-S durante la noche de las 24 primeras horas críticas se podría hacer más evidente esta insuficiencia resultando una mejor correlación entre estas hormonas, APACHE II y mortalidad. Diseño: Estudio observacional en pacientes críticos de la UTI del Hospital de Urgencia Asistencia Pública. Cuarenta y ocho (48) pacientes (30 hombres y 18 mujeres) sin antecedentes de: insuficiencia suprarrenal, uso de fenitoína, anticonvulsivantes, rifampicina, ketoconazol, corticosteroides, síndrome de Cushing, patología pituitaria, daño hepático crónico, insuficiencia renal crónica, alcoholismo activo crónico o readmisiones. EL APACHE II fue evaluado al ingreso. Cortisol y DHEA-S fueron medidos a las 00.00 de las primeras 24 h de su ingreso a UTI. Resultados: EL APACHE II (25,1±6,7 contra 16,3±7, p=0,001) y edad (59,5±15,8 contra 44,4±18,1, p 0,011) fueron significativamente más elevados en los fallecidos. En los fallecidos el cortisol mostró una tendencia a niveles más elevados. El DHEA-S mostró niveles considerablemente más altos en los sobrevivientes (5450,9±3824,0 contra 2980,3±2159,3 p= 0,03) junto como el índice DHEA-S/cortisol (12,66±14,19 contra 3,91±4,06, p= 0,004). Conclusiones: La tendencia a niveles más altos de cortisol nocturno observado en las 24 primeras horas induce para pensar que la insuficiencia suprarrenal relativa no desempeñaría un papel en las 24 primeras horas del estado crítico. Los niveles de DHEA-S y el índice DHEA-S/Cortisol son marcadores de sobrevida en nuestra población estudiada.

Vaginal fetal fibronectin and maternal dehydroepiandrosterone sulphate levels as selection criteria for induction of labour: a correlation study with bishop score

This study aimed to evaluate the predictive efficacy of two biochemical markers, the vaginal fetal fibronectin and maternal dehydroepiandrosterone sulfate for the fate of labor induction attempt. The reliability as well as the efficacy of their use together with Bishop score as selection criteria for induction of labor were also assessed. One hundred women with singleton pregnancies above 37 weeks gestation and with various indications for induction of labor with no signs of maternal of fetal compromise were enrolled in this study. After clinical assessment and fulfillment of selection criteria, patients were randomly allocated in two equal groups to have either vaginal fetal fibronectin [FFN] [GI=50] or maternal serum dehydroepiandrosterone sulfate [DHEAS] [GII=50] as a biochemical marker. Prior to induction of labor, all women were subjected to a detailed medical history, clinical examination including the cervical Bishop scoring, ultrasonographic assessment and estimation of the offered biochemical marker in each group. Induction-active phase interval was measured for all participants. The main outcome measures were mean concentrations of vaginal [FFN] and maternal [DHEAS], bishop score and induction-active phase interval. From this study, it was concluded that both fetal fibronectin and maternal dehydroepiandrosterone sulfate are effective predictors of the induction-active phase interval

Serum dehydroepiandrosterone sulfate, testosterone, and biochemical markers of bone turnover in elderly Thai men.

The most abundant human steroid, dehydroepiandrosterone sulfate (DHEAS), may have a multitude of beneficial effects, but declines with age. It is unclear whether DHEAS deficiency is an important factor contributing to increased bone resorption and impaired bone formation or not that leads to their bone loss. Thus, we investigated serum DHEAS, testosterone, osteocalcin (N-MID osteocalcin) and C-terminal telopeptides (beta-CrossLaps) in 121 healthy Thai males without bone diseases. Thirty-nine males (mean age 31.5 +/- 8.2, range 23-42 years) were recruited as the normal adult group and 82 males (mean age 61.2 +/- 7.0, range 52-77 years) were assigned as the elderly group. DHEAS levels were higher in the adult group compared with the elderly subjects (296.8 +/- 93.4 vs 172.6 +/- 99.8 microg/dL, p < 0.0001). Serum osteocalcin concentrations were also higher in the adult group compared with the elderly males (27.9 +/- 11.1 vs 23.2 +/- 7.9 ng/ml, p = 0.0091). However, serum testosterone and C-terminal telopeptides levels were not significantly different between the two groups. We concluded that low DHEAS concentrations are commonly encountered in elderly males and may relate to low osteocalcin levels due to the osteoblast stimulation effects of DHEAS. These findings may be implicated in the treatment of osteoporosis in elderly men by using DHEAS.

Correlación entre los niveles séricos de dehidhoepiandrosterona sulfato (DHEAS) con el estadío de maduración esquelética: primer informe / Correlation between seric levels of dehidroepiandrosterone sulfate (DHEAS) with the maturation skeletal stage

Con el fin de detectar un indicador del inicio del brote puberal, se correlacionaron los niveles séricos de DHEAS con el estadio de maduración esquelética (Taranger y Hagg), con la edad, el peso, la talla y con la madurez sexual (Tanner, orquidiometría de Prader). El estudio cuenta con 34 pacientes, 19 de género masculino y 15 de género femenino, entre los 8 y los 12 años de edad, a quienes se les tomaron datos, cada seis meses, los cuales se repetirán durante cuatro años. Este informe registra los datos de la muestra inicial. Se encontraron diferencias entre la madurez sexual de niños y niñas. Unicamente los niños presentaron niveles séricos mayores de Dehidroepiandrosterona sulfato (DHEAS) y menor madurez esquelética; mientras que las niñas presentaron mayor desarrollo esquelético y cifras mayores de DHEAS. En ambos grupos la DHEAS se correlacionó con el peso. La DHEAS se observó elevada en las niñas con desarrollo sexual mayor y la correlación entre ésta y la aparición del sesamoideo ulnar fue alta. Al parecer, la DHEAS se encuentra relacionada con el desarrollo esquelético aunque ello sólo podrá comprobarse con las mediciones posteriores

Produçäo de anticorpos monoclonais contra dehidroepiandrosterona (DHEA) e seuemprego no desenvolvimento de ensaios para a dosagem sérica de DHEA-sulfato (DHEA-S) / Monoclonal antiboidies against dehtdroepiandrosterone(DHEA) and their use in the development of assays for serum measurement of DHEA-sulphate (DHEA-S)

Neste trabalho, descrevemos nossa experiência na produçäo e caracterizaçäo de anticorpos monoclonais contra o sulfato de dehidroepiandrosterona (DHEA-S), sua caracterizaçäo e seu uso no desenvolvimento de radioimunoensaios tradicionais, mediante a comparaçäo dos resultados obtidos com um radioimunoensaio clássico empregando anticorpo policlonal. Foram caracterizados três anticorpos monoclonais (H6P4, B2P2 e G10p6) que apresentam coeficientes de afinidade entre 4 x 108 e 1,6 x 109 L/M e especificidades variáveis. A comparaçäo entre os valores obtidos com os três anticorpos monoclonais e aqueles obtidos com o ensaio tradicional mostrou excelente grau de correlaçäo. Os valores obtidos com o anticorpo monoclonal B2P2 apresentaram melhor índice de correlaçäo. Estudos adicionais mostraram que as características do ensaio, que empregou o anticorpo monoclonal B2P2, säo semelhantes àquelas do ensaio tradicional com anticorpo policlonal. Os anticorpos monoclonais obtidos podem servir de base para ensaios mais simples para a dosagem sérica de DHEA-S

Correlation between dehydroepiandrosterone sulfate [DHEA-S] and coronary artery disease

Dehydroepiandrosterone [DHEA] or it's sulfate derivative [DHEA-S] is the major C19 steroid hormone secreted by the adrenal cortex. It has been claimed that it has an inverse correlation with atherogenesis through its antiproliferative effect. The aim of this study is to examine the effect of DHEA-S on coronary artery disease[CAD]. In a prospective randomized study 202 patients with possible coronary artery disease who underwent coronary angiography between January 1999 and June 1999 were studied. They were allocated into two groups, group 1 [n=142, female: 39, male: 103] included patients who had more than 75% cross sectional area narrowing of at least one coronary artery, and group 2 [n=60, female: 28, male: 32] included patients who had no coronary artery disease. The age range was 18-75 years, and it was matched between the two groups. Level of DHEA-S [measured by two different methods; ELISA and RIA], fasting blood sugar, and full lipid profile [TG, total cholesterol, LDL-C, HDL-C] were measured in both groups. Other major coronary risk factors were also compared between the two groups. The level of DHEA-S had an inverse linear correlation with age [r=-0.34 and p<0.01]. There was no statistically significant correlation between the level of DHEA-S and coronary artery disease in different age groups in males or females. Likewise, there was no statistically significant correlation between the level of DHEA-S and blood sugar [p=0.08], HDL [p=0.41], LDL [p=0.09], body mass index [p=0.4], hypertension and current smoking. The present study does not confirm an inverse correlation between DHEA-S and coronary artery disease

Tumor virilizante de ovário: relato de um caso em paciente de 14 anos / Virilizing ovarian Tumor: report of a case in a patient 14 years old

Relatamos o caso de uma paciente com 14 anos de idade, que apresentou, voz rouca há dois anos, pilificaçäo exagerada há um ano e ausência de menarca. Ao exame físico foi constatado hirsutismo em regiäo supralabial, linha intermamária, linha alba e raiz da coxa. A paciente apresentou massa palpável em flanco esquerdo, de consistência maciça e endurecida. As investigaçöes laboratoriais revelaram níveis altos de testosterona, 512ng/dl (normal=30 a 90ng/dl). Os níveis de DHEA e DHEA-S se encontravam dentro dos valores normais. A ultasonografia pélvica e abdominal revelou massa complexa, predominantemente cística, ocupando a cavidade pélvica e abdominal inferior esquerda. A tomografia computadorizada revelou que tal massa apresentava dimensöes de 16x11x7 cm e se estendia superiormente à cicatriz umbilical por cerca de 4,0 cm. Foi indicada ooforectomia total esquerda. Um mês após a cirurgia a paciente apresentou menarca, diminuiçäo do hirsutismo e queda de níveis de testosterona (7ng/dl)

Efecto de la metformina sobre la resistencia insulínica en mujeres obesas y obesas hiperandrogénicas / Effects of metformin on insulin resistance in obese and hyperandrogenic women

Background: Metformin is a biguanide often used in obese diabetics that improves tissue sensitivity to insulin. Aim:To assess the effects of metformin on tissue insulin sensitivity in obese and byperandrogenic women. Patients and methods: Eight obese and eight obese and eight and hyperandrogenic women received metformin 850 mg orally during 12 weeks. Before and at the end of the treatment period, an insulin tolerance test to measure insulin sensitivity was performed and blood was drawn to measure sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), testosterone, triglycerides, total and HDL cholesterol. The free androgen index was calculated for each sample. Results: After metformin treatment, the insulin sensitivity index improved from 0.38 (0.05-0.5) to 0.43 (0.25-0.59) in obese and hyperandrogenic women. SHBG increased and total cholesterol and triglycerides decreased significantly in both groups. No other significant changes were observed. Conclusions: Metformin has a favorable effect on tissue sensitivity to insulin, SHBG and serum lipids in obese and hyperandrogenic women