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Дефицит андрогенов у женщин с надпочечниковой недостаточностью. Дегидроэпиандростерон. Обзор литературы
Дефицит андрогенов у женщин с надпочечниковой недостаточностью. Дегидроэпиандростерон. Обзор литературы
Нуралиева Н.Ф., Юкина М.Ю., Трошина Е.А., Платонова Н.М. Дефицит андрогенов у женщин с надпочечниковой недостаточностью. Дегидроэпиандростерон. Обзор литературы. Гинекология. 2018; 20 (4): 35–39.
DOI: 10.26442/2079-5696_2018.4.35-39
Gynecology. 2018; 20 (4): 35–39.
DOI: 10.26442/2079-5696_2018.4.35-39
DOI: 10.26442/2079-5696_2018.4.35-39
________________________________________________
Gynecology. 2018; 20 (4): 35–39.
DOI: 10.26442/2079-5696_2018.4.35-39
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Известно, что надпочечниковая недостаточность (НН) является тяжелым жизнеугрожающим заболеванием вследствие дефицита глюкокортикоидов и минералокортикоидов. В то же время дефицит андрогенов (дегидроэпиандростерон – ДГЭА и дегидроэпиандростерон-сульфат – ДГЭАС), синтезируемых корой надпочечников, также ассоциирован с увеличением риска смерти, в том числе от неблагоприятных сердечно-сосудистых событий, развитием остеопороза, сахарного диабета, злокачественных новообразований. У лиц женского пола ДГЭА и ДГЭАС секретируются преимущественно надпочечниками, соответственно, при НН наблюдается дефицит данных гормонов. Однако из-за отсутствия надежной доказательной базы коррекция андрогенодефицита у пациенток с НН, как правило, не проводится. В обзоре обсуждаются накопленные данные о физиологическом значении ДГЭА и ДГЭАС, их влиянии на различные патологические состояния, а также безопасности и эффективности назначения данных препаратов.
Ключевые слова: надпочечниковая недостаточность, дегидроэпиандростерон, дегидроэпиандростерон-сульфат, андрогены, андрогенодефицит у женщин.
At the same time, according to some reports, the deficit of androgens synthesized by the adrenal cortex (dehydroepiandrosterone – DHEA and dehydroepiandrosterone sulfate – DHEAS) is associated with an increased risk of death, including increased risk of adverse cardiovascular events, development of osteoporosis, diabetes mellitus and malignant neoplasms. The main source of DHEA and DHEAS in females are adrenal glands, so women with hypocorticism have significantly reduced (down to undetectable) levels of these hormones. However, due to lack of a reliable evidence and, accordingly, clinical recommendations, correction of androgen deficiency in patients with AI is usually not performed. The review discusses the accumulated data on the physiological significance of DHEA and DHEAS, their role in the development of various pathological conditions, as well as safety and efficacy of these drugs.
Key words: adrenal insufficiency, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androgens, androgen deficiency in women.
Ключевые слова: надпочечниковая недостаточность, дегидроэпиандростерон, дегидроэпиандростерон-сульфат, андрогены, андрогенодефицит у женщин.
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At the same time, according to some reports, the deficit of androgens synthesized by the adrenal cortex (dehydroepiandrosterone – DHEA and dehydroepiandrosterone sulfate – DHEAS) is associated with an increased risk of death, including increased risk of adverse cardiovascular events, development of osteoporosis, diabetes mellitus and malignant neoplasms. The main source of DHEA and DHEAS in females are adrenal glands, so women with hypocorticism have significantly reduced (down to undetectable) levels of these hormones. However, due to lack of a reliable evidence and, accordingly, clinical recommendations, correction of androgen deficiency in patients with AI is usually not performed. The review discusses the accumulated data on the physiological significance of DHEA and DHEAS, their role in the development of various pathological conditions, as well as safety and efficacy of these drugs.
Key words: adrenal insufficiency, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androgens, androgen deficiency in women.
Полный текст
Список литературы
1. Bornstein SR, Allolio B, Arlt W et al. Diagnosis and treatment of primary adrenal insufficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016; 101 (2): 364–89. DOI: 10.1210/jc.2015-1710
2. Юкина М.Ю., Трошина Е.А., Платонова Н.М., Бельцевич Д.Г. Надпочечниковая недостаточность. В кн.: Сборник методических рекомендаций. Под ред. чл.-кор. РАН Е.А.Трошиной. М.; Тверь: Триада, 2017. / Yukina M.Yu., Troshina E.A., Platonova N.M., Belcevich D.G. Nadpochechnikovaya nedostatochnost'. V kn.: Sbornik metodicheskih rekomendacij. Pod red. chl.-kor. RAN E.A.Troshinoj. M.; Tver': Triada, 2017. [in Russian]
3. Hughes IA, Chatterjee VK. Adrenarche and Adrenopause. Ed. 7. Elsevier, 2016. DOI: 10.1016/B978-0-323-18907-1.00105-0
4. Binder G, Weber S, Ehrismann M et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: A double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab 2009; 94 (4): 1182–90. DOI:10.1210/jc.2008-1982
5. Maninger N, Wolkowitz OM, Reus VI et al. Neurobiological and Neuropsychiatric Effects of Dehydroepiandrosterone (DHEA) and DHEA Sulfate (DHEAS). Front Neuroendocrinol 2009; 30 (1): 65–91. DOI:10.1016/j.yfrne.2008.11.002
6. Dhatariya K, Greenlund L. DHEA replacement in hypoadrenal women-investigation on protein anabolism and skeletal muscle function. Mayo Clin Proc 2008; 83 (11): 1218–25.
7. Young DG, Skibinski G, Mason JI et al. The influence of age and gender on serum dehydroepiandrosterone sulphate (DHEA-S), IL-6, IL-6 soluble receptor (IL-6 sR) and transforming growth factor beta 1 (TGF-beta1) levels in normal healthy blood donors. Clin Exp Immunol 999; 117 (3): 476–81. DOI: 10.1046/j.1365-2249.1999.01003.x
8. Stárka L, Rácz B, Šrámková M et al. Daily Profiles of Dehydroepiandrosterone and Its Hydroxylated Metabolites with Respect to Food Intake. Prague Med Rep 2015; 116 (1): 40–8. DOI: 10.14712/23362936.2015.44
9. Lang K, Burger-Stritt S, Hahner S. Is DHEA replacement beneficial in chronic adrenal failure? Best Pract Res Clin Endocrinol Metab 2015; 29 (1): 25–32. DOI: 10.1016/j.beem.2014.09.007
10. Lin L Te, Tsui KH, Wang PH et al. Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence. J Chinese Med Assoc 2015; 78 (8): 446–53. DOI: 10.1016/j.jcma.2014.12.008
11. Olech E, Merrill JT. DHEA supplementation: The claims in perspective. Cleve Clin J Med 2005; 72 (11): 965–84. DOI: 10.3949/ccjm.72.11.965
12. Hunt PJ, Gurnell EM, Huppert FА et al. Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial. J Clin Endocrinol Metab 2000; 85 (12): 4650–6. DOI: 10.1210/jcem.85.12.7022
13. Tsui KH, Lin L Te, Chang R et al. Effects of dehydroepiandrosterone supplementation on women with poor ovarian response: A preliminary report and review. Taiwan J Obstet Gynecol 2015; 54 (2): 131–6. DOI: 10.1016/j.tjog.2014.07.007
14. Гончаров Н.П., Кация Г.В. Дегидроэпиандростерон: биосинтез, метаболизм, биологическое действие и клиническое применение (аналитический обзор). Андрология и генитальная хирургия. 2015; 1: 13–22. DOI: 10.17650/2070-9781-2015-1-13-22 / Goncharov N.P., Kaciya G.V. Degidroehpiandrosteron: biosintez, metabolizm, biologicheskoe dejstvie i klinicheskoe primenenie (analiticheskij obzor). Andrologiya i genital'naya hirurgiya. 2015; 1: 13–22. DOI: 10.17650/2070-9781-2015-1-13-22 [in Russian]
15. Wierman ME, Arlt W, Basson R et al. Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2014; 99 (10): 3489–510. DOI:10.1210/jc.2014-2260
16. England TN. Dehydroepiandrosterone Replacement in Women With Adrenal Insufficiency. N Engl J Med 1999; 341 (14): 1013–20.
17. Srinivasan M, Irving BA, Dhatariya K et al. Effect of Dehydroepiandrosterone Replacement on Lipoprotein Profile in Hypoadrenal Women. J Clin Endocrinol Metab 2009; 94 (3): 761–4. DOI: 10.1210/jc.2008-1774
18. Dhatariya K, Bigelow ML, Nair KS. Effect of Dehydroepiandrosterone Replacement on Insulin Sensitivity and Lipids in Hypoadrenal Women. Diabetes 2005; 54 (3): 765–9. https://doi.org/10.2337/diabetes.54.3.765
19. Christiansen JJ, Bruun JM, Christiansen JS et al. Long-term DHEA substitution in female adrenocortical failure, body composition, muscle function, and bone metabolism: A randomized trial. Eur J Endocrinol 2011; 165 (2): 293–300. DOI: 10.1530/EJE-11-0289
20. Christiansen JJ, Gravholt CH, Fisker S et al. Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism. Eur J Endocrinol 2005; 152 (1): 77–85. DOI: 10.1530/eje.1.01810
21. Gurnell EM, Hunt PJ, Curran SE et al. Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial. J Clin Endocrinol Metab 2008; 93 (2): 400–9. DOI: 10.1210/jc.2007-1134
22. Alkatib AA, Cosma M, Elamin MB et al. A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials of DHEA Treatment Effects on Quality of Life in Women with Adrenal Insufficiency. J Clin Endocrinol Metab 2009; 94 (10): 3676–81. DOI: 10.1210/jc.2009-0672
23. Bouchard C, Labrie F, Derogatis L et al. VVA Prasterone Group. Effect of intravaginal dehydroepiandrosterone (DHEA) on the female sexual function in postmenopausal women: ERC-230 open-label study. Horm Mol Biol Clin Investig 2016; 25 (3): 181–90. DOI: 10.1515/hmbci-2015-0044
2. Yukina M.Yu., Troshina E.A., Platonova N.M., Belcevich D.G. Nadpochechnikovaya nedostatochnost'. V kn.: Sbornik metodicheskih rekomendacij. Pod red. chl.-kor. RAN E.A.Troshinoj. M.; Tver': Triada, 2017. [in Russian]
3. Hughes IA, Chatterjee VK. Adrenarche and Adrenopause. Ed. 7. Elsevier, 2016. DOI: 10.1016/B978-0-323-18907-1.00105-0
4. Binder G, Weber S, Ehrismann M et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: A double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab 2009; 94 (4): 1182–90. DOI:10.1210/jc.2008-1982
5. Maninger N, Wolkowitz OM, Reus VI et al. Neurobiological and Neuropsychiatric Effects of Dehydroepiandrosterone (DHEA) and DHEA Sulfate (DHEAS). Front Neuroendocrinol 2009; 30 (1): 65–91. DOI:10.1016/j.yfrne.2008.11.002
6. Dhatariya K, Greenlund L. DHEA replacement in hypoadrenal women-investigation on protein anabolism and skeletal muscle function. Mayo Clin Proc 2008; 83 (11): 1218–25.
7. Young DG, Skibinski G, Mason JI et al. The influence of age and gender on serum dehydroepiandrosterone sulphate (DHEA-S), IL-6, IL-6 soluble receptor (IL-6 sR) and transforming growth factor beta 1 (TGF-beta1) levels in normal healthy blood donors. Clin Exp Immunol 999; 117 (3): 476–81. DOI: 10.1046/j.1365-2249.1999.01003.x
8. Stárka L, Rácz B, Šrámková M et al. Daily Profiles of Dehydroepiandrosterone and Its Hydroxylated Metabolites with Respect to Food Intake. Prague Med Rep 2015; 116 (1): 40–8. DOI: 10.14712/23362936.2015.44
9. Lang K, Burger-Stritt S, Hahner S. Is DHEA replacement beneficial in chronic adrenal failure? Best Pract Res Clin Endocrinol Metab 2015; 29 (1): 25–32. DOI: 10.1016/j.beem.2014.09.007
10. Lin L Te, Tsui KH, Wang PH et al. Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence. J Chinese Med Assoc 2015; 78 (8): 446–53. DOI: 10.1016/j.jcma.2014.12.008
11. Olech E, Merrill JT. DHEA supplementation: The claims in perspective. Cleve Clin J Med 2005; 72 (11): 965–84. DOI: 10.3949/ccjm.72.11.965
12. Hunt PJ, Gurnell EM, Huppert FА et al. Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial. J Clin Endocrinol Metab 2000; 85 (12): 4650–6. DOI: 10.1210/jcem.85.12.7022
13. Tsui KH, Lin L Te, Chang R et al. Effects of dehydroepiandrosterone supplementation on women with poor ovarian response: A preliminary report and review. Taiwan J Obstet Gynecol 2015; 54 (2): 131–6. DOI: 10.1016/j.tjog.2014.07.007
14. Goncharov N.P., Kaciya G.V. Degidroehpiandrosteron: biosintez, metabolizm, biologicheskoe dejstvie i klinicheskoe primenenie (analiticheskij obzor). Andrologiya i genital'naya hirurgiya. 2015; 1: 13–22. DOI: 10.17650/2070-9781-2015-1-13-22 [in Russian]
15. Wierman ME, Arlt W, Basson R et al. Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2014; 99 (10): 3489–510. DOI:10.1210/jc.2014-2260
16. England TN. Dehydroepiandrosterone Replacement in Women With Adrenal Insufficiency. N Engl J Med 1999; 341 (14): 1013–20.
17. Srinivasan M, Irving BA, Dhatariya K et al. Effect of Dehydroepiandrosterone Replacement on Lipoprotein Profile in Hypoadrenal Women. J Clin Endocrinol Metab 2009; 94 (3): 761–4. DOI: 10.1210/jc.2008-1774
18. Dhatariya K, Bigelow ML, Nair KS. Effect of Dehydroepiandrosterone Replacement on Insulin Sensitivity and Lipids in Hypoadrenal Women. Diabetes 2005; 54 (3): 765–9. https://doi.org/10.2337/diabetes.54.3.765
19. Christiansen JJ, Bruun JM, Christiansen JS et al. Long-term DHEA substitution in female adrenocortical failure, body composition, muscle function, and bone metabolism: A randomized trial. Eur J Endocrinol 2011; 165 (2): 293–300. DOI: 10.1530/EJE-11-0289
20. Christiansen JJ, Gravholt CH, Fisker S et al. Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism. Eur J Endocrinol 2005; 152 (1): 77–85. DOI: 10.1530/eje.1.01810
21. Gurnell EM, Hunt PJ, Curran SE et al. Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial. J Clin Endocrinol Metab 2008; 93 (2): 400–9. DOI: 10.1210/jc.2007-1134
22. Alkatib AA, Cosma M, Elamin MB et al. A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials of DHEA Treatment Effects on Quality of Life in Women with Adrenal Insufficiency. J Clin Endocrinol Metab 2009; 94 (10): 3676–81. DOI: 10.1210/jc.2009-0672
23. Bouchard C, Labrie F, Derogatis L et al. VVA Prasterone Group. Effect of intravaginal dehydroepiandrosterone (DHEA) on the female sexual function in postmenopausal women: ERC-230 open-label study. Horm Mol Biol Clin Investig 2016; 25 (3): 181–90. DOI: 10.1515/hmbci-2015-0044
2. Юкина М.Ю., Трошина Е.А., Платонова Н.М., Бельцевич Д.Г. Надпочечниковая недостаточность. В кн.: Сборник методических рекомендаций. Под ред. чл.-кор. РАН Е.А.Трошиной. М.; Тверь: Триада, 2017. / Yukina M.Yu., Troshina E.A., Platonova N.M., Belcevich D.G. Nadpochechnikovaya nedostatochnost'. V kn.: Sbornik metodicheskih rekomendacij. Pod red. chl.-kor. RAN E.A.Troshinoj. M.; Tver': Triada, 2017. [in Russian]
3. Hughes IA, Chatterjee VK. Adrenarche and Adrenopause. Ed. 7. Elsevier, 2016. DOI: 10.1016/B978-0-323-18907-1.00105-0
4. Binder G, Weber S, Ehrismann M et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: A double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab 2009; 94 (4): 1182–90. DOI:10.1210/jc.2008-1982
5. Maninger N, Wolkowitz OM, Reus VI et al. Neurobiological and Neuropsychiatric Effects of Dehydroepiandrosterone (DHEA) and DHEA Sulfate (DHEAS). Front Neuroendocrinol 2009; 30 (1): 65–91. DOI:10.1016/j.yfrne.2008.11.002
6. Dhatariya K, Greenlund L. DHEA replacement in hypoadrenal women-investigation on protein anabolism and skeletal muscle function. Mayo Clin Proc 2008; 83 (11): 1218–25.
7. Young DG, Skibinski G, Mason JI et al. The influence of age and gender on serum dehydroepiandrosterone sulphate (DHEA-S), IL-6, IL-6 soluble receptor (IL-6 sR) and transforming growth factor beta 1 (TGF-beta1) levels in normal healthy blood donors. Clin Exp Immunol 999; 117 (3): 476–81. DOI: 10.1046/j.1365-2249.1999.01003.x
8. Stárka L, Rácz B, Šrámková M et al. Daily Profiles of Dehydroepiandrosterone and Its Hydroxylated Metabolites with Respect to Food Intake. Prague Med Rep 2015; 116 (1): 40–8. DOI: 10.14712/23362936.2015.44
9. Lang K, Burger-Stritt S, Hahner S. Is DHEA replacement beneficial in chronic adrenal failure? Best Pract Res Clin Endocrinol Metab 2015; 29 (1): 25–32. DOI: 10.1016/j.beem.2014.09.007
10. Lin L Te, Tsui KH, Wang PH et al. Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence. J Chinese Med Assoc 2015; 78 (8): 446–53. DOI: 10.1016/j.jcma.2014.12.008
11. Olech E, Merrill JT. DHEA supplementation: The claims in perspective. Cleve Clin J Med 2005; 72 (11): 965–84. DOI: 10.3949/ccjm.72.11.965
12. Hunt PJ, Gurnell EM, Huppert FА et al. Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial. J Clin Endocrinol Metab 2000; 85 (12): 4650–6. DOI: 10.1210/jcem.85.12.7022
13. Tsui KH, Lin L Te, Chang R et al. Effects of dehydroepiandrosterone supplementation on women with poor ovarian response: A preliminary report and review. Taiwan J Obstet Gynecol 2015; 54 (2): 131–6. DOI: 10.1016/j.tjog.2014.07.007
14. Гончаров Н.П., Кация Г.В. Дегидроэпиандростерон: биосинтез, метаболизм, биологическое действие и клиническое применение (аналитический обзор). Андрология и генитальная хирургия. 2015; 1: 13–22. DOI: 10.17650/2070-9781-2015-1-13-22 / Goncharov N.P., Kaciya G.V. Degidroehpiandrosteron: biosintez, metabolizm, biologicheskoe dejstvie i klinicheskoe primenenie (analiticheskij obzor). Andrologiya i genital'naya hirurgiya. 2015; 1: 13–22. DOI: 10.17650/2070-9781-2015-1-13-22 [in Russian]
15. Wierman ME, Arlt W, Basson R et al. Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2014; 99 (10): 3489–510. DOI:10.1210/jc.2014-2260
16. England TN. Dehydroepiandrosterone Replacement in Women With Adrenal Insufficiency. N Engl J Med 1999; 341 (14): 1013–20.
17. Srinivasan M, Irving BA, Dhatariya K et al. Effect of Dehydroepiandrosterone Replacement on Lipoprotein Profile in Hypoadrenal Women. J Clin Endocrinol Metab 2009; 94 (3): 761–4. DOI: 10.1210/jc.2008-1774
18. Dhatariya K, Bigelow ML, Nair KS. Effect of Dehydroepiandrosterone Replacement on Insulin Sensitivity and Lipids in Hypoadrenal Women. Diabetes 2005; 54 (3): 765–9. https://doi.org/10.2337/diabetes.54.3.765
19. Christiansen JJ, Bruun JM, Christiansen JS et al. Long-term DHEA substitution in female adrenocortical failure, body composition, muscle function, and bone metabolism: A randomized trial. Eur J Endocrinol 2011; 165 (2): 293–300. DOI: 10.1530/EJE-11-0289
20. Christiansen JJ, Gravholt CH, Fisker S et al. Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism. Eur J Endocrinol 2005; 152 (1): 77–85. DOI: 10.1530/eje.1.01810
21. Gurnell EM, Hunt PJ, Curran SE et al. Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial. J Clin Endocrinol Metab 2008; 93 (2): 400–9. DOI: 10.1210/jc.2007-1134
22. Alkatib AA, Cosma M, Elamin MB et al. A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials of DHEA Treatment Effects on Quality of Life in Women with Adrenal Insufficiency. J Clin Endocrinol Metab 2009; 94 (10): 3676–81. DOI: 10.1210/jc.2009-0672
23. Bouchard C, Labrie F, Derogatis L et al. VVA Prasterone Group. Effect of intravaginal dehydroepiandrosterone (DHEA) on the female sexual function in postmenopausal women: ERC-230 open-label study. Horm Mol Biol Clin Investig 2016; 25 (3): 181–90. DOI: 10.1515/hmbci-2015-0044
________________________________________________
2. Yukina M.Yu., Troshina E.A., Platonova N.M., Belcevich D.G. Nadpochechnikovaya nedostatochnost'. V kn.: Sbornik metodicheskih rekomendacij. Pod red. chl.-kor. RAN E.A.Troshinoj. M.; Tver': Triada, 2017. [in Russian]
3. Hughes IA, Chatterjee VK. Adrenarche and Adrenopause. Ed. 7. Elsevier, 2016. DOI: 10.1016/B978-0-323-18907-1.00105-0
4. Binder G, Weber S, Ehrismann M et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: A double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab 2009; 94 (4): 1182–90. DOI:10.1210/jc.2008-1982
5. Maninger N, Wolkowitz OM, Reus VI et al. Neurobiological and Neuropsychiatric Effects of Dehydroepiandrosterone (DHEA) and DHEA Sulfate (DHEAS). Front Neuroendocrinol 2009; 30 (1): 65–91. DOI:10.1016/j.yfrne.2008.11.002
6. Dhatariya K, Greenlund L. DHEA replacement in hypoadrenal women-investigation on protein anabolism and skeletal muscle function. Mayo Clin Proc 2008; 83 (11): 1218–25.
7. Young DG, Skibinski G, Mason JI et al. The influence of age and gender on serum dehydroepiandrosterone sulphate (DHEA-S), IL-6, IL-6 soluble receptor (IL-6 sR) and transforming growth factor beta 1 (TGF-beta1) levels in normal healthy blood donors. Clin Exp Immunol 999; 117 (3): 476–81. DOI: 10.1046/j.1365-2249.1999.01003.x
8. Stárka L, Rácz B, Šrámková M et al. Daily Profiles of Dehydroepiandrosterone and Its Hydroxylated Metabolites with Respect to Food Intake. Prague Med Rep 2015; 116 (1): 40–8. DOI: 10.14712/23362936.2015.44
9. Lang K, Burger-Stritt S, Hahner S. Is DHEA replacement beneficial in chronic adrenal failure? Best Pract Res Clin Endocrinol Metab 2015; 29 (1): 25–32. DOI: 10.1016/j.beem.2014.09.007
10. Lin L Te, Tsui KH, Wang PH et al. Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence. J Chinese Med Assoc 2015; 78 (8): 446–53. DOI: 10.1016/j.jcma.2014.12.008
11. Olech E, Merrill JT. DHEA supplementation: The claims in perspective. Cleve Clin J Med 2005; 72 (11): 965–84. DOI: 10.3949/ccjm.72.11.965
12. Hunt PJ, Gurnell EM, Huppert FА et al. Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial. J Clin Endocrinol Metab 2000; 85 (12): 4650–6. DOI: 10.1210/jcem.85.12.7022
13. Tsui KH, Lin L Te, Chang R et al. Effects of dehydroepiandrosterone supplementation on women with poor ovarian response: A preliminary report and review. Taiwan J Obstet Gynecol 2015; 54 (2): 131–6. DOI: 10.1016/j.tjog.2014.07.007
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Авторы
Н.Ф.Нуралиева*, М.Ю.Юкина, Е.А.Трошина, Н.М.Платонова
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России. 117036, Россия, Москва, ул. Дмитрия Ульянова, д. 11
*dr.nuralievanf@yandex.ru
National Medical Research Center of Endocrinology of the Ministry of Health of Russian Federation. 117036, Russian Federation, Moscow, ul. Dmitry Ulyanov, d. 11
*dr.nuralievanf@yandex.ru
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России. 117036, Россия, Москва, ул. Дмитрия Ульянова, д. 11
*dr.nuralievanf@yandex.ru
________________________________________________
National Medical Research Center of Endocrinology of the Ministry of Health of Russian Federation. 117036, Russian Federation, Moscow, ul. Dmitry Ulyanov, d. 11
*dr.nuralievanf@yandex.ru
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