Abstract P355: Variable associations of dehydroepiandrosterone with cardiovascular risk factors in the Boston Puerto Rican Health Study

Abstract

Introduction: Low blood levels of dehydroepiandrosterone sulfate (DHEAS) have been shown to have strong positive associations with diabetes, cardiovascular disease (CVD) mortality and stroke. However, the underlying pathways remain unclear, given limited data to systematically examine associations of DHEAS with CVD risk. In exploratory analyses we tested the association between CVD risk factors and DHEAS levels in a large population of Latinos. Methods: Among 1,450 participants in the Boston Puerto Rican Health Study between the ages of 45-75 years at baseline, socio-demographic, behavior, medical history, anthropometric and blood pressure data were collected at in-home interviews conducted by trained staff. A certified phlebotomist collected fasting blood samples. All samples were assayed for DHEAS, lipids, and C-reactive protein (CRP), HbA1c, insulin and glucose (GL). Spearman correlations were estimated between DHEAS and continuous CVD risk factors (lipids, systolic blood pressure [SBP] and diastolic blood pressure [DBP], CRP, GL, HbA1c, insulin, body mass index [BMI], waist circumference, physical activity and alcohol consumptions). We used robust multivariable linear regression models adjusted for potential confounders and intermediates with α=0.05 to estimate the association selected CVD risk factors and DHEAS levels. CVD risk factors were identified from a set of potential candidate predictors (age, female gender, history of heart disease, diabetes status, SBP, DBP, total and high density cholesterol [TC, HDL], triglycerides [TG], GL, CRP) using stepwise linear regression with an entry criterion of α=0.20 and exit criterion of α=0.10. Results: The mean DHEAS concentration among women was 70.7 μg/dL (s.d. 53.9; median=70.7) and among men was 119 μg/dL (s.d. 87.7; median=100). In age and sex adjusted Spearman correlations, TC, low density lipoprotein cholesterol, physical activity and alcohol were positively significantly correlated with DHEAS, while BMI and waist circumference were inversely correlated. In robust multivariable linear regression adjusted for potential confounders, age (-8.3; 95%CI:-10.0,-6.5; per 5 yrs), sex (β=-32.5; 95%CI:-38.4,-26.6) and TG (β=-0.5; 95%CI:-0.7,-0.2; per 10 mg/dl) were significantly inversely associated with DHEAS concentration, while TC (β=0.9; 95%CI:0.2,1.6;per 10 mg/dL) and GL (β=0.7; 95%CI:0.2, 1.2;per 10 mg/dL) were positively associated, albeit non-statistically significant. Adjustment for history of CVD, diabetes and BMI, only marginally attenuated these associations. Conclusions: Our data provide support for a significant association between TG levels and DHEAS concentrations even after adjustment for potential confounders and intermediates, which has been previously untested. These results suggest that DHEAS may work through lipid pathways.