Department of Psychiatry, Temple University School of Medicine, Philadelphia, PA, 19140, USA.
Arch Womens Ment Health. 2011 Oct;14(5):375-82. doi: 10.1007/s00737-011-0231-5. Epub 2011 Jul 20.
The influence of sex hormones on mood during the menopausal transition has been the subject of ongoing investigation. Because dehydroepiandrosterone sulfate (DHEA-S) has been associated with several indicators of healthy aging, we conducted a population-based study of midlife women to determine the relationship between DHEA-S levels and depressive symptoms and major depression during the transition through menopause. Unexpectedly, the original report revealed a positive correlation between DHEA-S levels and depressive symptoms at baseline. The cohort was studied over 11 years to determine whether the positive association between DHEA-S levels and depression persists through the menopausal transition. We conducted a longitudinal cohort study with 11 assessments during an 11-year interval in Philadelphia, Pennsylvania, using a randomly identified, population-based sample of 436 African American and Caucasian premenopausal women aged 35 to 47 years at enrollment. For outcome measures, we used the Center for Epidemiologic Studies Depression Scale and standardized diagnosis of major depression. In a multivariable model, DHEA-S levels were positively associated with depressive symptoms when adjusted for age, menopausal stage, race, smoking status, and body mass index. There was no association between DHEA-S levels and a diagnosis of major depression. DHEA-S levels were positively associated with depressive symptoms through the menopausal transition. No association with major depression was apparent during the menopausal transition, but results may have limited power due to low prevalence of major depression in this cohort. These findings suggest that taking DHEA supplements may increase depressive symptoms for some women, and women and their physicians should be cautious about instituting DHEA replacement therapy during the menopausal transition.
性激素对绝经过渡期情绪的影响一直是正在进行的研究课题。因为硫酸脱氢表雄酮（DHEA-S）与健康老龄化的几个指标有关，我们对中年女性进行了一项基于人群的研究，以确定 DHEA-S 水平与抑郁症状和绝经过渡期间的重度抑郁症之间的关系。出乎意料的是，最初的报告显示 DHEA-S 水平与基线时的抑郁症状之间存在正相关。该队列研究了 11 年，以确定 DHEA-S 水平与抑郁之间的正相关是否在绝经过渡期间持续存在。我们在宾夕法尼亚州费城进行了一项为期 11 年的纵向队列研究，使用随机确定的、基于人群的 436 名年龄在 35 至 47 岁的绝经前非裔美国人和白种人女性样本进行研究。对于结局测量，我们使用了流行病学研究中心抑郁量表和重度抑郁症的标准化诊断。在多变量模型中，调整年龄、绝经阶段、种族、吸烟状况和体重指数后，DHEA-S 水平与抑郁症状呈正相关。DHEA-S 水平与重度抑郁症诊断之间没有关联。DHEA-S 水平与绝经过渡期间的抑郁症状呈正相关。在绝经过渡期间，与重度抑郁症没有关联，但由于该队列中重度抑郁症的患病率较低，结果可能效力有限。这些发现表明，服用 DHEA 补充剂可能会增加某些女性的抑郁症状，女性及其医生在绝经过渡期间应谨慎考虑进行 DHEA 替代疗法。
