A Prospective Study of Dehydroepiandrosterone Sulfate, Mortality, and Cardiovascular Disease

Abstract

It has been postulated that dehydroepiandrosterone (DHEA) and its sulfate ester, dehydroepiandrosterone sulfate (DHEAS), the major secretory products of the human adrenal gland, may be discriminators of life expectancy and aging. We examined the relation of base-line circulating DHEAS levels to subsequent 12-year mortality from any cause, from cardiovascular disease, and from ischemic heart disease in a population-based cohort of 242 men aged 50 to 79 years at the start of the study. Mean DHEAS levels decreased with age and were also significantly lower in men with a history of heart disease than in those without such a history. In men with no history of heart disease at base line, the age-adjusted relative risk associated with a DHEAS level below 140 micrograms per deciliter was 1.5 (P not significant) for death from any causes, 3.3 (P less than 0.05) for death from cardiovascular disease, and 3.2 (P less than 0.05) for death from ischemic heart disease. In multivariate analyses, an increase in DHEAS level of 100 micrograms per deciliter was associated with a 36 percent reduction in mortality from any causes (P less than 0.05) and a 48 percent reduction in mortality from cardiovascular disease (P less than 0.05), after adjustment for age, systolic blood pressure, serum cholesterol level, obesity, fasting plasma glucose level, cigarette smoking status, and personal history of heart disease. Our conclusions are limited by the single determination of DHEAS levels, but the data suggest that the DHEAS concentration is independently and inversely related to death from any cause and death from cardiovascular disease in men over age 50.

Endocrinological late effects after chemotherapy for testicular cancer

“…Recently, it has become clear that, by means of steroid sulphotransferase/sulphate interconvertable hormones, they themselves participate in a striking number of physiological and pathological processes (Parker, 1995), although gross symptoms of clinical withdrawal following experimental adrenalectomy are not observed (Regelson et al, 1994). The metabolism of DHEAS with its unique physiological age-dependent decline after a peak at the age of approx 24 years (Orentreich et al, 1984) has been considered as a marker for life expectancy and biological ageing (Barrett-Connor et al, 1986). Despite a circadian rhythm, single-spot samples measured at a standardised time of day can give representative information on DHEAS levels (Bain et al, 1988).…”

“…Information available on serum cholesterol levels after ctx is limited and partially controversial (Ellis et al, 1992;Gietema et al, 1992;Raghavan et al, 1992) and little is known on the potential associations between cholesterol levels and changes of sex hormones or adrenal androgenshormones that themselves have been postulated to be related to life expectancy and ageing (Barrett-Connor et al, 1986). The interactions between these hormones and cholesterol metabolism may influence the risk of cardiovascular disease.…”

Komorbiditeti kod oboljelih od reumatoidnog artritisa

“…I druga istraživanja pokazala su da bolesnici od RA imaju dva do četiri puta viši rizik od razvoja infarkta miokarda, što upućuje na ubrzanu aterosklerozu u bolesnika od RA [17]. Bolesnici od RA ne samo da imaju povišen rizik za znatan broj komorbiditeta, već je i ishod tih komorbiditeta gori nego u bolesnika bez RA.…”

“…"nijemi infarkt" i naglu srčanu smrt. Aterosklerotski plakovi u bolesnika od RA češće su nekalcifikovani i stoga vulnerabilniji [17]. Uz infarkt miokarda, nezavisno od dobi, incidencija zatajenja srca u bolesnika od RA, takođe, je približno dva puta veća u odnosu na opštu populaciju [18].…”

“…U jednom od radova ispitivanu grupu je sačinja-vala 1091 osoba, od kojih je 7% bolesnika imalo endoskopski verifikovan peptički ulkus. Od te grupe bolesnika, 30 je imalo peptički ulkus povezan sa upotrebom NSAIL i 46 bolesnika ulkus druge etiologije [17]. Od bolesnika sa hroničnim gastritisom (n = 599), 71 bolesnik je imao pozitivan test na Helicobacter pylori, a 108 bolesnika je uzimalo NSAIL.…”