Low DHEA-S levels up risk of heart failure, death

06 Jan 2021
Low DHEA-S levels up risk of heart failure, death

Low levels of dehydroepiandrosterone-sulfate (DHEA-S) contribute to a higher risk of heart failure (HF) and mortality, but not coronary heart disease (CHD), according to a study.

To examine the link between low DHEA-S/DHEA-S change and incident HF hospitalization, CHD, and mortality in older adults, the investigators measured stored plasma from visits 4 (1996–1998) and 5 (2011–2013) of the Atherosclerosis Risk in Communities Study. A total of 8,143 individuals (mean age, 63 years) without prevalent cardiovascular disease were included. Follow-up for incident events was 18 years for DHEA-S level and 5.5 years for change in DHEA-S.

DHEA-S below the 15th sex-specific percentile of the study population (men: 55.4 µg/dL; women: 27.4 µg/dL) correlated with a higher risk of HF hospitalization (men: hazard ratio [HR], 1.30, 95 percent confidence interval [CI], 1.07–1.58; women: HR, 1.42, 95 percent CI, 1.13–1.79).

Moreover, DHEA-S below the 25th sex-specific percentile (men: 70.0 µg/dL; women: 37.1 µg/dL) correlated with a higher risk of mortality (men: HR, 1.12, 95 percent CI, 1.01–1.25; women: HR, 1.19, 95 percent CI, 1.03–1.37).

Greater percentage decrease in DHEA-S in men was associated with an increased risk of HF hospitalization (HR, 1.94, 95 percent CI, 1.11–3.39), but not in women. Of note, low DHEA-S and change in DHEA-S did not correlate with incident CHD.

“Further investigation is warranted to evaluate mechanisms underlying these associations,” the investigators said.

J Clin Endocrinol Metab 2020;105:e4304-e4327