Baylor College of Medicine, Houston, Texas.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Clin Endocrinol Metab. 2020 Dec 1;105(12):e4304-27. doi: 10.1210/clinem/dgaa518.
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.
Assess associations between low DHEA-S/DHEA-S change and incident HF hospitalization, CHD, and mortality in older adults.
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.
General community.
Individuals without prevalent cardiovascular disease (n = 8143, mean age 63 years).
Associations between DHEA-S and incident HF hospitalization, CHD, or mortality; associations between 15-year change in DHEA-S (n = 3706) and cardiovascular events.
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.
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.
脱氢表雄酮硫酸盐（DHEA-S）水平与冠心病（CHD）和死亡率的关系不一致。心力衰竭（HF）的数据有限，以及 DHEA-S 变化与事件之间的关系。
评估老年人中低 DHEA-S/DHEA-S 变化与新发 HF 住院、CHD 和死亡率之间的关系。
在社区动脉粥样硬化风险研究的第 4 次（1996-1998 年）和第 5 次（2011-2013 年）就诊时，从储存的血浆中测量了 DHEA-S。对新发事件的随访：DHEA-S 水平为 18 年；DHEA-S 变化为 5.5 年。
一般社区。
无明显心血管疾病的个体（n=8143，平均年龄 63 岁）。
DHEA-S 与新发 HF 住院、CHD 或死亡率之间的关系；15 年 DHEA-S 变化（n=3706）与心血管事件之间的关系。
DHEA-S 低于研究人群第 15 个性别特异性百分位数（男性：55.4 µg/dL；女性：27.4 µg/dL），与 HF 住院增加相关（男性：风险比[HR]1.30，95%置信区间[CI]，1.07-1.58；女性：HR 1.42，95% CI，1.13-1.79）；DHEA-S 低于第 25 个性别特异性百分位数（男性：70.0 µg/dL；女性：37.1 µg/dL）与死亡率增加相关（男性：HR 1.12，95% CI，1.01-1.25；女性：HR 1.19，95% CI，1.03-1.37）。在男性中，但不是女性中，DHEA-S 百分比下降幅度较大与 HF 住院增加相关（HR 1.94，95% CI，1.11-3.39）。低 DHEA-S 和 DHEA-S 变化与新发 CHD 无关。
低 DHEA-S 与 HF 风险增加和死亡率增加相关，但与 CHD 无关。需要进一步研究以评估这些关联的潜在机制。
