DHEA and mortality: What is the nature of the association?. Issue 145 (January 2015)

• Record Type: Journal Article
• Authors: Ohlsson, Claes; Vandenput, Liesbeth; Tivesten, Åsa
• Is Part Of: Journal of steroid biochemistry and molecular biology. Issue 145(2015)
• Page Start: 248
• Page End: 253
• Publication Date: 2015-01
• Subjects: Dehydroepiandrosterone -- Dehydroepiandrosterone sulfate -- Mortality; DHEA dehydroepiandrosterone -- DHEA-S DHEA sulfate -- CV cardiovascular -- IHD ischemic heart disease -- AI adrenal insufficiency -- GWAS genome-wide association study; Steroid hormones -- Periodicals; Biochemistry -- Periodicals; Hormones -- Periodicals; Molecular Biology -- Periodicals; Hormones stéroïdes -- Périodiques; Steroid hormones; Periodicals; 572.579
• DOI: 10.1016/j.jsbmb.2014.03.006
• Languages: English
• ISSNs: 0960-0760

Abstract

Highlights: Larger studies support an association between DHEA/-S levels and mortality risk in elderly men. In women, the association may not be present; alternatively, there may be a U-shaped association. Most available evidence suggests an association with CV mortality rather than cancer mortality. There are biologically plausible mechanisms for an effect of DHEA/-S on CV disease. On the other hand, there is also strong evidence supporting that any disease may lower DHEA/-S. Abstract: Although very little is known about the importance of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEA-S) in human physiology and pathophysiology, emerging observations imply pivotal roles of DHEA/-S. One such observation is the association between serum DHEA/-S levels and mortality risk. In this review, we focus on the literature addressing DHEA/-S and mortality with the aim to describe and discuss patterns and potential underlying mechanisms. Although the literature reports somewhat inconsistent results, we conclude that several larger population-based studies support an association between low DHEA/-S and risk of death, at least in elderly men. In women, the association may not be present; alternatively, there may be a U-shaped association. In men, most available evidence suggests an association with cardiovascular (CV) mortality rather than cancer mortality. Further, there are biologically plausible mechanisms for an effect of DHEA/-S on the development of CV disease. On the other hand, there is also strong evidence supporting that any disease may lower DHEA/-S. Thus, the cause-effect relation of this association is less clear. Future studies may employ a mendelian randomization approach using genetic determinants of DHEA-S levels as predictors of clinical outcomes, to delineate the true nature of the association between DHEA/-S and mortality.