Johannes C B, Stellato R K, Feldman H A, Longcope C, McKinlay J B
New England Research Institutes, Watertown, Massachusetts 02472, USA.
J Clin Epidemiol. 1999 Feb;52(2):95-103. doi: 10.1016/s0895-4356(98)00144-9.
Low circulating levels of the adrenal steroids dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) are thought to be associated with increased risk of cardiovascular disease (CVD) in men. In women, either a positive or null association with CVD has been found. The nature of the relation between DHEAS and CVD risk factors in women is unclear and is based on cross-sectional data. We present results from a longitudinal investigation of serum DHEA and DHEAS and cardiovascular disease risk factors in 236 women, initially 50-60 years old, from a population-based prospective (1986-1995) study of the menopausal transition. We used generalized estimating equations to model the relation of serum DHEA and DHEAS to systolic and diastolic blood pressure and serum levels of total cholesterol, high density lipoprotein cholesterol, and apolipoproteins A and B, adjusting for other factors related to CVD. Both DHEA and DHEAS were positively related to diastolic and systolic blood pressure, and DHEAS was negatively related to apolipoprotein A. DHEA and DHEAS were also positively related to smoking, alcohol use, estrone, and estradiol levels, and inversely related to age. Our results suggest that higher levels of DHEA and DHEAS in middle-aged women may indicate increased CVD risk.
肾上腺类固醇脱氢表雄酮（DHEA）和硫酸脱氢表雄酮（DHEAS）的循环水平较低被认为与男性心血管疾病（CVD）风险增加有关。在女性中，已发现与CVD存在正相关或无关联。DHEAS与女性CVD风险因素之间关系的性质尚不清楚，且基于横断面数据。我们展示了一项针对236名女性血清DHEA和DHEAS以及心血管疾病风险因素的纵向调查结果，这些女性最初年龄在50 - 60岁，来自一项基于人群的前瞻性（1986 - 1995年）绝经过渡研究。我们使用广义估计方程来模拟血清DHEA和DHEAS与收缩压和舒张压以及总胆固醇、高密度脂蛋白胆固醇、载脂蛋白A和B的血清水平之间的关系，并对与CVD相关的其他因素进行了调整。DHEA和DHEAS均与舒张压和收缩压呈正相关，DHEAS与载脂蛋白A呈负相关。DHEA和DHEAS还与吸烟、饮酒、雌酮和雌二醇水平呈正相关，与年龄呈负相关。我们的结果表明，中年女性中较高水平的DHEA和DHEAS可能表明CVD风险增加。
