Mukama T, Johnson T, Katzke V, Kaaks R. Dehydroepiandrosterone sulphate and mortality in middle-aged and older men and women - a J-shaped relationship.
J Clin Endocrinol Metab 2022;
108:e313-e325. [PMID:
36477484 DOI:
10.1210/clinem/dgac716]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
CONTEXT
The relationship between DHEAS and mortality is of scientific and public health interest, yet remains poorly understood.
OBJECTIVE
Examine the association between DHEAS and cancer, cardiovascular and all-cause mortality in middle-aged and older men and women.
DESIGN
Case-cohort nested within EPIC-Heidelberg. DHEAS was measured in 7,370 stored serum collected from 1994 to 1998. Median follow-up for incident mortality events: 17.7 years.
SETTING
General community.
PARTICIPANTS
The case-cohort included 7,370 men (mean age = 55.0) and women (mean age = 52.4 years). All deaths due to cancer (n = 1040), cardiovascular diseases (n = 598) and all causes (n = 2407) which occurred in EPIC-Heidelberg until end of 2014 were included.
RESULTS
The association between DHEAS and mortality was non-linear such that both participants in the lowest (Q1) and highest (Q5) sex- and 5-year age-group specific quintiles of DHEAS were at increased hazards of mortality from cardiovascular [Q1: HR = 1.83 95%CI: (1.33-2.51), Q5: 1.39 (1.00-1.94)], cancer [Q1: 1.27 (1.01-1.60), Q5: 1.27 (1.02-1.60)] and all causes [Q1: 1.51 (1.25-1.82), Q5: 1.31 (1.08-1.58)], compared to participants in Q3. In men and women with below median DHEAS levels, doubling of DHEAS was associated with lower hazards of cardiovascular [0.87, (0.78-0.96)], cancer [0.90, (0.83-0.97)], and total mortality [0.89, (0.83-0.95)]. In contrast, a doubling in DHEAS among participants with above median levels was associated with 1.20, (1.01-1.42), 1.28, (1.01-1.62) and 1.19 (1.03-1.37) higher hazards of mortality from cancer, cardiovascular, and all-causes respectively.
CONCLUSION
In this large population based study, DHEAS showed a J-shaped association with mortality. Both participants with lowest and highest levels experienced higher hazards of mortality from cancer, cardiovascular and all causes.
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