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心血管疾病与高龄人群中脱氢表雄酮硫酸盐下降幅度增大相关:心血管健康研究全明星研究。

Cardiovascular disease is associated with greater incident dehydroepiandrosterone sulfate decline in the oldest old: the cardiovascular health study all stars study.

机构信息

Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

J Am Geriatr Soc. 2010 Mar;58(3):421-6. doi: 10.1111/j.1532-5415.2010.02724.x. Epub 2010 Feb 16.

Abstract

OBJECTIVES

To describe cross-sectional and longitudinal associations with dehydroepiandrosterone sulfate (DHEAS) and change in DHEAS with age.

DESIGN

Longitudinal cohort study.

SETTING

Pittsburgh, Pennsylvania.

PARTICIPANTS

Cardiovascular Health Study All Stars study participants assessed in 2005/06 (N=989, mean age 85.2, 63.5% women, 16.5% African American).

MEASUREMENTS

Health characteristics were assessed in 2005/06 according to DHEAS level, mean DHEAS and DHEAS change across age categories were tested, and linear and logistic regression was used to identify factors present in 1996/97 associated with continuous and categorical DHEAS change.

RESULTS

Mean +/- standard deviation DHEAS was 0.555 +/- 0.414 microg/mL in 1996/97 and 0.482 +/- 0.449 microg/mL in 2005/06 for women and 0.845 +/- 0.520 microg/mL in 1996/97 and 0.658 +/- 0.516 microg/mL in 2005/06 for men. In 2005/06, DHEAS was lower in women and subjects with cardiovascular disease (CVD) and chronic pulmonary disease and higher for African Americans and subjects with hypertension and high cholesterol. Mean DHEAS change was greater in men (-0.200 microg/mL) than in women (-0.078 microg/mL) (P<.001). Each 1-year increase in age attenuated the effect of male sex by 0.01 microg/mL (P=.009), abolishing the sex difference in DHEAS change by age 79. Presence of CVD before the study period was associated with greater absolute DHEAS change (beta=-0.04 microg/mL, P=.04) and with the fourth quartile of DHEAS change versus the first to third quartiles (odds ratio=1.46, 95% confidence interval=1.03-2.05).

CONCLUSION

DHEAS change continues into very old age, is not homogenous, is affected by sex, and is associated with prevalent CVD. Future studies should investigate factors that might accelerate DHEAS decline.

摘要

目的

描述与硫酸脱氢表雄酮(DHEAS)的横断面和纵向关联,以及 DHEAS 随年龄的变化。

设计

纵向队列研究。

地点

宾夕法尼亚州匹兹堡。

参与者

心血管健康研究全明星研究参与者于 2005/06 年评估(N=989,平均年龄 85.2,63.5%女性,16.5%非裔美国人)。

测量

根据 DHEAS 水平评估 2005/06 年的健康特征,测试平均 DHEAS 和 DHEAS 随年龄组的变化,线性和逻辑回归用于确定 1996/97 年存在的与连续和分类 DHEAS 变化相关的因素。

结果

女性 1996/97 年的平均(+/-标准偏差)DHEAS 为 0.555(+/-0.414)μg/mL,2005/06 年为 0.482(+/-0.449)μg/mL,男性 1996/97 年为 0.845(+/-0.520)μg/mL,2005/06 年为 0.658(+/-0.516)μg/mL。在 2005/06 年,女性和患有心血管疾病(CVD)和慢性肺部疾病的患者的 DHEAS 水平较低,非裔美国人以及患有高血压和高胆固醇的患者的 DHEAS 水平较高。2005/06 年男性的平均 DHEAS 变化(-0.200μg/mL)大于女性(-0.078μg/mL)(P<.001)。每增加 1 岁,男性性别对 DHEAS 变化的影响就会降低 0.01μg/mL(P=.009),从而在 79 岁时消除了性别对 DHEAS 变化的差异。在研究期间之前存在 CVD 与更大的绝对 DHEAS 变化(β=-0.04μg/mL,P=.04)以及与第四四分位 DHEAS 变化相比第一至第三四分位(比值比=1.46,95%置信区间=1.03-2.05)相关。

结论

DHEAS 变化持续到非常高龄,并非同质,受性别影响,与常见的 CVD 相关。未来的研究应该调查可能加速 DHEAS 下降的因素。

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