Low Levels of Prohormone Predicts Coronary Heart Disease

The adrenal sex hormone dehydroepiandrosterone (DHEA), which is present in serum mainly as the sulfate DHEA-S, is the most abundant steroid hormone in human blood and its levels decline dramatically with age.

DHEA is a prohormone that is produced by the adrenal glands and can be converted to active sex hormones and men with low levels of DHEA in the blood run, and maybe a predictor of, an increased risk of developing coronary heart disease (CHD) events.

Scientists at the Sahlgrenska Academy (University of Gothenburg, Sweden) and their colleagues used gas and liquid chromatography-mass spectrometry to analyze baseline levels of DHEA and DHEA-S in a prospective population-based study in Sweden of 2,416 men, ages 69 to 81 years. They monitored the men for five years and complete cardiovascular clinical outcomes were available from national Swedish registers. The analytes and the internal standard were detected using the HP5973 quadrupole mass spectrometer (Agilent Technologies; Santa Clara, CA, USA) equipped with a chemical ionization source.

There were 302 participants who experienced a CHD event, and 225 had a cerebrovascular disease (CBD) event during the five-year follow-up. Both DHEA and DHEA-S levels were inversely associated with the age-adjusted risk of a CHD event; the hazard ratios and 95% confidence intervals per standard deviation (SD) increase were 0.82 (0.73 to 0.93) and 0.86 (0.77 to 0.97), respectively. In contrast, DHEA-S showed no statistically significant association with the risk of CBD events. The association between DHEA and CHD risk remained significant after adjustment for traditional cardiovascular risk factors, serum total testosterone and estradiol, C-reactive protein, and renal function, and remained unchanged after exclusion of the first 2.6 years of follow-up to reduce reverse causality.

The authors concluded that low serum levels of DHEA and its sulfate predict an increased risk of CHD, but not CBD, events in elderly men. Åsa Tivesten, MD, PhD, the lead author of the study said, “Endogenous production of DHEA appears to be a protective factor against coronary heart disease. High DHEA levels may also be a biomarker of generally good health in elderly men.” The study was published on October 21, 2014, in the Journal of the American College of Cardiology.

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