Dehydroepiandrosterone, a sex-hormone precursor that has been marketed in many countries as an ‘anti-aging’ supplement, may actually promote formation of fatty plaques in arteries, according to laboratory findings published in the December 3rd issue of the Journal of the American College of Cardiology.

"Our lab study shows a surprising result that dehydroepiandrosterone may promote coronary disease, rather than prevent it, and while it is a lab result, it does suggest that caution should be taken in the unsupervised self-administration of the hormone. It seems to suggest to us that any administration [of the hormone] in humans at the moment should probably be restricted to the context of research, rather than over-the-counter use," said Dr. Martin K. C. Ng, lead author of the study.

In the in vitro research, the Australian investigators exposed human macrophage cells to dehydroepiandrosterone, an androgen-receptor antagonist, or both. Unexposed cells were used as controls. Exposure to dehydroepiandrosterone produced a dose-dependent effect that appeared similar to an early stage in the formation of arterial fatty plaques: Specifically, the exposed cells showed increases in the cholesterol ester content. Large amounts of cholesterol ester give macrophage cells a foamy appearance, which is the basis for the term ‘foam cell.’

"It's the earliest and principal cell in early coronary disease," Ng said. "It's really the earliest hallmark of coronary disease that we know of."

The researchers found no effect of exposure on adhesion of monocytes to human endothelial cells, another early event in the formation of plaques.

Ng noted the inability to extrapolate directly to in vivo conditions. "Someone taking dehydroepiandrosterone does not experience an increase just [in that compound]. They seem to have an increase in other circulating androgens, male sex hormones, as well, so the effects may be more complicated in a person."

There is some observational evidence in humans linking higher natural levels of dehydroepiandrosterone with higher rates of coronary disease. For instance, women in the United States and men in Japan both have lower rates of coronary disease---and lower levels of dehydroepiandrosterone ---than men in the United States.

Sam Tsimikas, MD, who was not part of the research team, said "This adds to the growing evidence that anabolic steroids, or precursors thereof, such as dehydroepiandrosterone, may have detrimental effects on cardiovascular health. With data showing that approximately 1 out of 2 Americans will eventually die of cardiovascular disease, this information has major health care implications, and more research will be needed to fully understand its effects on heart disease. With several highly publicized recent events where athletes have died in the setting of using performance enhancing supplements, it adds an imperative for potential users of such supplements to be cautious."