Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
NHC Key Laboratory of Hormones and Development, Tianjin Medical University, Tianjin, China.
Front Endocrinol (Lausanne). 2022 Jun 15;13:915494. doi: 10.3389/fendo.2022.915494. eCollection 2022.
The associations of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) with diabetic kidney disease (DKD) remained unclear. Thus, this cross-sectional study aimed to explore the associations of DHEA and DHEAS with the risk of DKD in patients with T2DM.
The information of 1251 patients with T2DM were included in this study. Serum DHEA and DHEAS were quantified using liquid chromatography-tandem mass spectrometry assays. Multivariate logistic regression analyses were used to assess the associations of DHEA and DHEAS with DKD as well as high urine albumin to creatinine ratio (ACR).
In men with T2DM, the risk of DKD decreased with an increasing DHEA concentration after adjustment for traditional risk factors; the fully adjusted OR (95% CI) for tertile3 vs tertile1 was 0.37 (0.19-0.70; P = 0.010 for trend). Similarly, when taking high ACR as the outcome, low DHEA levels were still significantly associated with increased odds of high ACR (OR, 0.37; 95% CI, 0.19-0.72 for tertile3 vs tertile1; P = 0.012 for trend). The restricted cubic spline showed that the risk of DKD gradually decreased with the increment of serum DHEA levels (P-overall = 0.007; P-nonlinear = 0.161). DHEAS was not independently associated with the risk of DKD in men. In contrast, no significant relationships were found between DHEA and DHEAS and the risk of DKD in women (all P > 0.05).
In men with T2DM, low serum DHEA levels were independently related to the risk of DKD after adjustment for traditional risk factors. Our finding highlights the potential role of DHEA in the development of DKD in men with T2DM.
脱氢表雄酮(DHEA)和硫酸脱氢表雄酮(DHEAS)与糖尿病肾病(DKD)的关系尚不清楚。因此,本横断面研究旨在探讨 DHEA 和 DHEAS 与 2 型糖尿病(T2DM)患者 DKD 风险的关系。
本研究纳入了 1251 名 T2DM 患者的资料。采用液相色谱-串联质谱法测定血清 DHEA 和 DHEAS。采用多变量 logistic 回归分析评估 DHEA 和 DHEAS 与 DKD 以及高尿白蛋白与肌酐比值(ACR)的关系。
在男性 T2DM 患者中,校正传统危险因素后,DHEA 浓度增加与 DKD 风险降低相关;第 3 三分位与第 1 三分位相比,OR(95%CI)为 0.37(0.19-0.70;趋势 P = 0.010)。同样,以高 ACR 为结局时,低 DHEA 水平仍与高 ACR 的发生风险增加显著相关(OR,0.37;95%CI,第 3 三分位与第 1 三分位相比为 0.19-0.72;趋势 P = 0.012)。限制立方样条显示,随着血清 DHEA 水平的升高,DKD 的发病风险逐渐降低(P 总体=0.007;P 非线性=0.161)。DHEAS 与男性 DKD 风险无独立相关性。相反,在女性中,DHEA 和 DHEAS 与 DKD 风险之间未发现显著关系(均 P>0.05)。
在男性 T2DM 患者中,校正传统危险因素后,低血清 DHEA 水平与 DKD 风险独立相关。我们的研究结果强调了 DHEA 在男性 T2DM 患者 DKD 发生发展中的潜在作用。