Effects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: A systematic review and meta-analysis of randomised clinical trials.

Background and aims Dehydroepiandrosterone (DHEA) supplementation has been investigated in patients with altered cortisol levels and is proposed to ameliorate the metabolic profile related to adipose tissue. However, further research is warranted and evidence is no compelling for liver safety. Hence, we aimed to meta-analyze the effects of DHEA supplementation on circulating levels of cortisol, liver enzymes, and adipokines. Methods We searched literature published in PubMed, Web of Science, Embase, and Scopus, until December 2020. We obtained overall results using the generic inverse of variance method with a random-effects model. Results Through 10 arms, serum cortisol levels decreased significantly after DHEA supplementation [weighted mean difference (WMD): -53.581 nmol/L, 95% confidence interval (CI): -88.2, -18.9, p = 0.002], without significant heterogeneity (I2 = 36%, p = 0.117). In contrast, any significance was noted for adiponectin (WMD: -0.045 ug/ml, 95% CI: -0.56, 0.47; p = 0.865), leptin (WMD: -2.55 ug/ml, 95% CI: -6.2, 1.06; p = 0.166), aspartate transaminase (AST) (WMD: -3.7 U/L, 95% CI: -10.35, 2.95; p = 0.276), and alanine aminotransferase (ALT) (WMD: -1.7 U/L, 95% CI: -3.45, 0.06; p = 0.058). Conclusion DHEA supplementation decreased circulating cortisol but did not alter adiponectin, leptin, AST, and ALT levels. Hence, DHEA supplementation could be considered as an adjunct in the management of hypercortisolemia and is safe for the liver.