Circulation, Vol 86, 1529-1535, Copyright © 1992 by American Heart Association
AZ LaCroix, K Yano and DM Reed
BACKGROUND. Antiatherogenic effects of dehydroepiandrosterone (DHEA) and
dehydroepiandrosterone sulfate (DHEAS) have been suspected for more than 30
years, yet the available evidence to support or refute such effects in
humans is inconclusive. The hypothesis has not been adequately tested in
large-scale epidemiological studies. METHODS AND RESULTS. The present study
used a cohort of men initially free of clinically detectable coronary heart
disease, stroke, and cancer to compare DHEAS levels measured in sera
obtained in 1968-1971 between 238 cases who had definite coronary heart
disease during the subsequent 18 years and 476 age-matched controls who
survived the follow-up period and remained free of clinically detectable
coronary heart disease. In a separate study, the relation of DHEAS levels
to extent of atherosclerosis was examined among 82 cohort men who died
during the follow-up period and had protocol autopsies. Age-adjusted DHEAS
levels were lower among fatal cases of coronary heart disease than among
controls (94.7 versus 106.9 micrograms/dl, respectively; p < 0.05).
After adjustment for eight coronary risk factors, the odds ratio for fatal
coronary heart disease comparing a 100-micrograms/dl difference in DHEAS
level was 0.46 (95% confidence intervals, 0.19-1.07). In contrast,
age-adjusted DHEAS levels did not significantly differ between nonfatal
cases of myocardial infarction and controls (107.2 versus 106.9
micrograms/dl, respectively). Furthermore, DHEAS levels were not related to
extent of atherosclerosis at autopsy. CONCLUSIONS. These findings do not
support a role of DHEAS in the development of nonfatal myocardial
infarction or the progression of atherosclerosis. The association of DHEAS
with fatal coronary heart disease and possibly with death from all causes
merits further investigation. These findings suggest continued skepticism
that DHEAS has an important role in coronary disease etiology or
prevention.
ARTICLES
Dehydroepiandrosterone sulfate, incidence of myocardial infarction, and extent of atherosclerosis in men
Department of Epidemiology, University of Washington, Seattle.
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