Low plasma DHEA-S increases mortality risk among male hemodialysis patients

Hsu, Heng-Jung; Yen, Chiung-Hui; Chen, Chih-Ken; Hsu, Kuang-Hung; Hsiao, Chih‐Cheng; Lee, Chin‐Chan; Wu, I-Wen; Sun, Chiao‐Yin; Chou, Chia-Chi; Hsieh, Ming-Fang; Chen, Chun-Yu; Hsu, Chun‐Chun; Tsai, Chi-Jen; Wu, Mai-Szu

doi:10.1016/j.exger.2012.08.012

Cited by 13 publications

(19 citation statements)

References 36 publications

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“…In men, the main adrenal androgens are DHEA and its interconvertible sulphated form, DHEAS. In contrast to previous studies using single immunoassay‐based measurements, we did not find an independent association of adrenal androgens with mortality in men with CKD. This is consistent with the fact that the adrenal contribution to the pool of biologically active androgens in men is very small.…”

Section: Discussioncontrasting

confidence: 99%

Sex steroids levels in chronic kidney disease and kidney transplant recipients: associations with disease severity and prediction of mortality

Grossmann

Hoermann

Fui

et al. 2014

Clinical Endocrinology

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Section: Discussioncontrasting

confidence: 99%

Sex steroids levels in chronic kidney disease and kidney transplant recipients: associations with disease severity and prediction of mortality

Grossmann

Hoermann

Fui

et al. 2014

Clinical Endocrinology

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“…Epidemiological studies demonstrate that the association between low DHEAS and all‐cause disease or CVD mortality is conflicting. Most of the studies in men show a negative relationship between DHEAS level and mortality and CVD mobility . Similar conclusions in postmenopausal women with low DHEAS levels have been reported and are associated with higher cardiovascular mortality .…”

Section: Discussionsupporting

confidence: 72%

“…Eleven were excluded based on study design. Overall, 25 cohort studies, with a total of 92 489 CVD patients, were included in our systematic review . For each of these studies, we extracted items including year of publication, name of the first author, country of origin of the research group, sample number of studies included, design used in the studies, quality evaluation of the studies, follow‐up time, confounder for adjustments, DHEAS concentration gradient, and end point.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies investigated deficient DHEAS level and fatal cardiovascular events, 7 studies investigated low DHEAS and nonfatal cardiovascular events, and 1 study reported DHEAS with fatal/nonfatal cardiovascular events separately. In the meta‐analysis, the pooled estimates for the lowest compared with the highest category of baseline DHEAS indicated a significant increased risk for fatal cardiovascular events without heterogeneity ( I 2 =0%): pooled risk ratio, 1.58 (95% CI, 1.30–1.91; P <0.00001 [Figure ]).…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Value of Dehydroepiandrosterone Sulfate for Patients With Cardiovascular Disease: A Systematic Review and Meta‐Analysis

Wang

Yuan

Zhou

et al. 2017

JAHA

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BackgroundThe aim of the present study was to estimate the impact of dehydroepiandrosterone sulfate (DHEAS) on the prognosis of patients with cardiovascular disease by performing a systematic review and meta‐analysis.Methods and ResultsThe Embase, PubMed, Web of Science, CNKI, and WanFang databases were searched up to September 5, 2016, to identify eligible studies. The quality of each study was assessed using the Newcastle‐Ottawa Scale. The association between DHEAS, either on admission or at discharge, and cardiovascular disease outcomes were reviewed. The overall risk ratio for the effect of DHEAS on all‐cause mortality and fatal and nonfatal cardiovascular events was pooled using a fixed‐effects or a random‐effects model. The publication bias was evaluated using funnel plots. Twenty‐five studies were included for systematic review. The follow‐up duration ranged from 1 to 19 years. Eighteen studies were included in the meta‐analysis. We found that lower DHEAS levels indicated a significant increased risk for all‐cause mortality (risk ratio, 1.47; 95% CI, 1.38–1.56 [P<0.00001]), fatal cardiovascular event (risk ratio, 1.58; 95% CI, 1.30–1.91 [P<0.00001]), and nonfatal cardiovascular event (risk ratio, 1.42; 95% CI, 1.24–1.62 [P<0.0001]) in patients with cardiovascular disease.ConclusionsPatients with cardiovascular disease who have lower DHEAS levels may have poorer prognosis than those with higher DHEAS levels.

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“…A study on 494 HD patients found that DHEA‐S levels were lower than in healthy controls and also predicted mortality in the male patients . This association between DHEA‐S and mortality in male hemodialysis patients was later confirmed by Hsu et al The studies investigating the relation between sex hormone and mortality are summarized in Table .…”

Section: Sex Hormones and Mortalitymentioning

confidence: 85%

Hormonal changes in hemodialysis patients: Novel risk factors for mortality?

Güngör

Koçyiğit

Carrero

et al. 2017

Seminars in Dialysis

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Patients with end-stage renal disease undergoing dialysis commonly experience derangements in the hypothalamic-pituitary-gonadal axis together with alterations at the level of synthesis and clearance of many hormones. This hormonal imbalance, even if asymptomatic, has recently been associated with increased mortality in these patients. In this review, we summarize observational and mechanistic evidence linking hormonal alterations at the level of the thyroid and sex-hormone systems with this mortality risks.

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Low plasma DHEA-S increases mortality risk among male hemodialysis patients

Cited by 13 publications

References 36 publications

Sex steroids levels in chronic kidney disease and kidney transplant recipients: associations with disease severity and prediction of mortality

Sex steroids levels in chronic kidney disease and kidney transplant recipients: associations with disease severity and prediction of mortality

Prognostic Value of Dehydroepiandrosterone Sulfate for Patients With Cardiovascular Disease: A Systematic Review and Meta‐Analysis

Hormonal changes in hemodialysis patients: Novel risk factors for mortality?

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