Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
Front Endocrinol (Lausanne). 2022 Jun 27;13:890029. doi: 10.3389/fendo.2022.890029. eCollection 2022.
Sex hormones play an important role in the pathogenesis of cardiovascular disease (CVD). This cross-sectional study aimed to explore the associations of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) with coronary heart disease (CHD) and stroke in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).
A total of 995 patients with T2DM were included in the study analysis. Serum levels of DHEA and DHEAS were quantified using liquid chromatography-tandem mass spectrometry. Binary logistic regression analyses were performed to assess the associations of DHEA and DHEAS with CHD and stroke. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal DHEA and DHEAS cutoff values for the detection of CHD in men with T2DM.
In men with T2DM, after adjustment for potential confounders in model 3, the risk of CHD decreased with an increasing serum DHEA level [odds ratio (OR) = 0.38, quartile 4 . quartile 1; 95% confidence interval (CI) = 0.16-0.90; = 0.037 for trend). Consistently, when considered as a continuous variable, this association remained significant in the fully adjusted model (OR = 0.59, 95% CI = 0.40-0.87, < 0.05). When taken as a continuous variable in model 3, serum DHEAS level was also inversely related to the risk of CHD among men (OR = 0.56, 95% CI = 0.38-0.82, < 0.05). Similarly, this relationship remained statistically significant when DHEAS was categorized into quartiles (OR = 0.27, quartile 4 . quartile 1; 95% CI = 0.11-0.67; = 0.018 for trend). ROC curve analyses revealed that the optimal cutoff values to detect CHD in men with T2DM were 6.43 nmol/L for DHEA and 3.54 μmol/L for DHEAS. In contrast, no significant associations were found between DHEA and DHEAS on the one hand and stroke on the other in men and women with T2DM (all > 0.05).
Serum DHEA and DHEAS were significantly and negatively associated with CHD in middle-aged and elderly men with T2DM. This study suggests potential roles of DHEA and DHEAS in CHD pathogenesis.
性激素在心血管疾病（CVD）的发病机制中起着重要作用。本横断面研究旨在探讨脱氢表雄酮（DHEA）和硫酸脱氢表雄酮（DHEAS）与 2 型糖尿病（T2DM）中老年患者冠心病（CHD）和中风的关系。
共纳入 995 例 T2DM 患者进行研究分析。采用液相色谱-串联质谱法定量检测血清 DHEA 和 DHEAS 水平。采用二元逻辑回归分析评估 DHEA 和 DHEAS 与 CHD 和中风的相关性。采用受试者工作特征（ROC）曲线分析确定 T2DM 男性中 DHEA 检测 CHD 的最佳 DHEA 和 DHEAS 截断值。
在 T2DM 男性中，在校正模型 3 中的潜在混杂因素后，随着血清 DHEA 水平的升高，CHD 的风险降低[比值比（OR）=0.38，四分位 4 . 四分位 1；95%置信区间（CI）=0.16-0.90；趋势检验=0.037]。同样，当作为连续变量考虑时，这种关联在完全校正模型中仍然显著（OR=0.59，95%CI=0.40-0.87， < 0.05）。在校正模型 3 中，血清 DHEAS 水平也与男性 CHD 风险呈负相关（OR=0.56，95%CI=0.38-0.82， < 0.05）。同样，当 DHEAS 分为四分位数时，这种关系仍然具有统计学意义（OR=0.27，四分位 4 . 四分位 1；95%CI=0.11-0.67；趋势检验=0.018）。ROC 曲线分析显示，T2DM 男性中检测 CHD 的最佳 DHEA 截断值为 6.43 nmol/L，DHEAS 为 3.54 μmol/L。相反，在 T2DM 男性和女性中，DHEA 和 DHEAS 与中风之间没有显著关联（均 > 0.05）。
血清 DHEA 和 DHEAS 与 T2DM 中老年男性的 CHD 显著负相关。本研究提示 DHEA 和 DHEAS 在 CHD 发病机制中可能发挥作用。
