Plasma dehydroepiandrosterone sulfate and cardiovascular disease risk in older men and women

Author(s):

Jia X, Sun C, Tang O, Gorlov I, Nambi V, Virani SS, Villareal DT, Taffet GE, Yu B, Bressler J, Boerwinkle E, Windham BG, de Lemos JA, Matsushita K, Selvin E, Michos ED, Hoogeveen RC, Ballantyne CM

Keywords:

Categories:

Publication:

J Clin Endocrinol Metab . 2020 Dec 1;105(12):e4304-e4327.

Publication Link:

DOI Link:

https://doi.org/10.1210/clinem/dgaa518

Context

Lower dehydroepiandrosterone-sulfate (DHEA-S) levels have been inconsistently associated with coronary heart disease (CHD) and mortality. Data are limited for heart failure (HF) and association between DHEA-S change and events.

Objective

Assess associations between low DHEA-S/DHEA-S change and incident HF hospitalization, CHD, and mortality in older adults.

Design

DHEA-S was measured in stored plasma from visits 4 (1996–1998) and 5 (2011–2013) of the Atherosclerosis Risk in Communities study. Follow-up for incident events: 18 years for DHEA-S level; 5.5 years for DHEA-S change.

Setting

General community.

Participants

Individuals without prevalent cardiovascular disease (n = 8143, mean age 63 years).

Main outcome measure

Associations between DHEA-S and incident HF hospitalization, CHD, or mortality; associations between 15-year change in DHEA-S (n = 3706) and cardiovascular events.

Results

DHEA-S below the 15th sex-specific percentile of the study population (men: 55.4 µg/dL; women: 27.4 µg/dL) was associated with increased HF hospitalization (men: hazard ratio [HR] 1.30, 95% confidence interval [CI], 1.07–1.58; women: HR 1.42, 95% CI, 1.13–1.79); DHEA-S below the 25th sex-specific percentile (men: 70.0 µg/dL; women: 37.1 µg/dL) was associated with increased death (men: HR 1.12, 95% CI, 1.01–1.25; women: HR 1.19, 95% CI, 1.03–1.37). In men, but not women, greater percentage decrease in DHEA-S was associated with increased HF hospitalization (HR 1.94, 95% CI, 1.11–3.39). Low DHEA-S and change in DHEA-S were not associated with incident CHD.

Conclusions

Low DHEA-S is associated with increased risk for HF and mortality but not CHD. Further investigation is warranted to evaluate mechanisms underlying these associations.

© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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