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. 2017 Jan;60(1):98-106.
doi: 10.1007/s00125-016-4136-8. Epub 2016 Oct 22.

Serum dehydroepiandrosterone levels are associated with lower risk of type 2 diabetes: the Rotterdam Study

Adela Brahimaj  1 , Taulant Muka  2 , Maryam Kavousi  2 , Joop S E Laven  3 , Abbas Dehghan  2 , Oscar H Franco  2
Affiliations

Serum dehydroepiandrosterone levels are associated with lower risk of type 2 diabetes: the Rotterdam Study

Adela Brahimaj et al. Diabetologia. 2017 Jan.

Abstract

Aims/hypothesis: Previous literature documents controversial results for the impact of dehydroepiandrosterone (DHEA) in glucose metabolism. We aimed to assess the associations between serum levels of DHEA and its main derivatives DHEA sulphate (DHEAS) and androstenedione, as well as the ratio of DHEAS to DHEA, and risk of type 2 diabetes.

Methods: We used data on serum levels of DHEA, DHEAS and androstenedione from 5189 middle-aged and elderly men and women from the prospective population-based Rotterdam Study. Type 2 diabetes was defined as a fasting blood glucose ≥7.0 mmol/l or a non-fasting blood glucose ≥11.1 mmol/l.

Results: During a median follow-up of 10.9 years, 643 patients with incident type 2 diabetes were identified. After adjusting for age, sex, cohort, fasting status, fasting glucose and insulin, and BMI, both serum DHEA levels (per 1 unit natural log-transformed, HR 0.76, 95% CI 0.67, 0.87) and serum DHEAS levels (per 1 unit natural log-transformed, HR 0.82, 95% CI 0.73, 0.92) were inversely associated with risk of type 2 diabetes in the total population. Further adjustment for alcohol, smoking, physical activity, prevalent cardiovascular disease, serum total cholesterol, use of lipid-lowering medications, systolic BP, treatment for hypertension, C-reactive protein, oestradiol and testosterone did not substantially affect the association between DHEA and incident type 2 diabetes (per 1 unit natural log-transformed, HR 0.80, 95% CI 0.65, 0.99), but abolished the association between DHEAS and type 2 diabetes. Androstenedione was not associated with risk of type 2 diabetes, nor was DHEAS to DHEA ratio.

Conclusions/interpretation: DHEA serum levels might be an independent marker of type 2 diabetes.

Keywords: Androstenedione; DHEA; DHEAS; Food supplement; Independent marker; Type 2 diabetes.

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Conflict of interest statement

Data availability

Data can be obtained upon request. Requests should be directed towards the management team of the Rotterdam Study (secretariat.epi@erasmusmc.nl), which has a protocol for approving data requests. Because of restrictions based on privacy regulations and informed consent of the participants, data cannot be made freely available in a public repository.

Duality of interest statement

TM and OHF work at ErasmusAGE, a centre for ageing research across the life course that is funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA. OHF reports receiving grants or research support from Metagenics Inc. These funding sources had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review or approval of the manuscript. The other authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

AB, TM and OHF conceived and designed the study. AB and TM analysed the data. AB wrote the first draft of the article. All authors revised the article critically for important intellectual content and gave final approval of the version to be published. All authors have read, and confirm that they meet, ICMJE criteria for authorship. AB is the guarantor of this work.

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