Serum Dehydroepiandrosterone Sulfate and Risk for Type 2 Diabetes in Older Men and Women: The Pro.V.A Study

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• 作者：Nicola Veronese ; MD^a ; ^{ilmannato@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Caterina Trevisan ; MD^a ; Marina De Rui ; MD^a ; Francesco Bolzetta ; MD^a ; Stefania Maggi ; MD^b ; Sabina Zambon ; MD^b ; ^c ; Maria Chiara Corti ; MD^d ; Giovannella Baggio ; MD^e ; Egle Perissinotto ; ScD^f ; Gaetano Crepaldi ; MD^b ; Enzo Manzato ; MD^a ; ^b ; Giuseppe Sergi ; MD^a
• 关键词：community-dwelling adults ; DHEAS ; Elderly ; type 2 diabetes
• 刊名：Canadian Journal of Diabetes
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：40
• 期：2
• 页码：158-163
• 全文大小：305 K

文摘

A large body of clinical data suggests the importance of endogenous sex hormones in the pathogenesis of diabetes, but very little is known about the possible relationship between dehydroepiandrosterone sulfate (DHEAS) and diabetes, particularly in the elderly. We aimed, therefore, to examine whether high serum levels of DHEAS have any protective effects on the incidence of type 2 diabetes and to elucidate the possible role of gender in a cohort of older subjects.

Methods

We followed 1258 community-dwelling subjects aged ≥65 years without type 2 diabetes who belonged to the Progetto Veneto Anziani (Pro.V.A.) for 4.4±1.2 years. DHEAS were measured at baseline and categorized into gender-specific tertiles. The incidence of type 2 diabetes was diagnosed in cases of fasting plasma glucose above 7.0 nmol/L, glycated hemoglobin ≥6.5%, use of glucose-lowering drugs or a 2-hour postload blood sugar level ≥11.1 nmol/L during the follow-up period.

Results

Although no significant differences in potential risk factors for diabetes were apparent across DHEAS tertiles at the baseline in either gender, when those with lower DHEAS were taken for reference, Cox regression analysis showed that males in the highest DHEAS tertile had lower risks for being diagnosed with diabetes during the follow up (HR=0.23; 95% CI: 0.11–0.51; p<0.0001), whereas no significant differences emerged across DHEAS tertiles for females or for the sample as a whole.

Conclusions

Higher serum DHEAS levels revealed a significant protective effect against the onset of type 2 diabetes in older men but not in older women, confirming different sensitivities of type 2 diabetes to DHEAS between genders.