Serum Dehydroepiandrosterone Sulfate Levels Research Articles

Association of serum cortisol and dehydroepiandrosterone sulfate (DHEAS) levels with psychological stress in patients with vitiligo

Background/aimVitiligo is a depigmentation disorder that leads to serious psychological burden in patients, who are frequently reported to have depression and anxiety. The aim of this study was to investigate the association between stress-related hormone levels and psychological stress in vitiligo. Materials and methodsIn this study 46 vitiligo patients and 46 controls were enrolled; their cortisol, dehydroepiandrosterone sulfate (DHEAS), and cortisol/DHEAS levels were measured. Psychological burden was assessed by the Beck Depression Inventory and Perceived Stress Scale. ResultsPatients and controls did not differ in terms of cortisol, DHEAS, or cortisol/DHEAS. Patients had higher perceived stress than controls but did not differ in terms of depression scores. Correlation analyses revealed that cortisol/DHEAS correlated positively with perceived stress (P = 0.009, r = 0.272). The correlation between cortisol/DHEAS and perceived stress was stronger in the patient group (P = 0.013, r = 0.363) and close to zero among controls. In regression analyses, lower depression and higher perceived stress were shown to predict cortisol/DHEAS values. ConclusionVitiligo patients significantly differed from the healthy population in terms of hormones and psychological distress. There was also an association between perceived stress and cortisol/DHEAS ratio in vitiligo. Abnormality of hormonal response to distress lowers DHEAS, which is known for its antioxidant properties, a possible mechanism for vitiligo development. Another important finding is the significance of using the composite variable cortisol/DHEAS, which seems to be more sensitive to distress than each of its components. We suggest its use in future studies on psychological distress–hormone relationships.

Effect of forest bathing (shinrin-yoku) on human health: A review of the literature

Humans have enjoyed forest environments for ages because of the quiet atmosphere, beautiful scenery, mild climate, pleasant aromas, and fresh, clean air. In Japan, since 2004, serial studies have been conducted to investigate the effects of forest environments on human health. We have established a new medical science called Forest Medicine. The Forest Medicine is a new interdisciplinary science, belonging to the categories of alternative medicine, environmental medicine and preventive medicine, which encompasses the effects of forest environments on human health. It has been reported that forest environments have the following beneficial effects on human health:1.Increase human natural killer (NK) activity, the number of NK cells, and the intracellular levels of anti-cancer proteins, suggesting a preventive effect on cancers.2.Reduce blood pressure, heart rate, and stress hormones, such as urinary adrenaline and noradrenaline and salivary cortisol.3.Increase the activity of parasympathetic nerves and reduce the activity of sympathetic nerves.4.Increase the levels of serum adiponectin and dehydroepiandrosterone sulfate.5.In the Profile of Mood States (POMS) test, reduce the scores for anxiety, depression, anger, fatigue, and confusion, and increase the score for vigor, showing psychological effects as well.These findings suggest that forest environments may have preventive effects on lifestyle-related diseases.

Supplementation of concentrated Kurozu, a Japanese black vinegar, reduces the onset of hepatic steatosis in mice fed with a high-fat diet

Background: Hepatic steatosis is among the most common causes of chronic liver diseases, although established effective treatments are not evident. Previous studies reported that Kurozu improved hypercholesterolemia and carbohydrate metabolism. However, the effect of Kurozu on the incidence of hepatic steatosis is not clear.Objective: The effect of Kurozu on the onset of hepatic steatosis by administering a high-fat diet (HFD) for 110 weeks was evaluated in C57BL/6J mice. Methods: HFD treatment for 110 weeks accelerated the onset of hepatic steatosis more than a standard diet, whereas concentrated Kurozu (CK) supplementation ameliorated the effect of an HFD feeding. The effect of supplementation with resveratrol in an HFD on the onset of hepatic steatosis was also evaluated. To elucidate the mechanism of the effect of Kurozu on the expression of lipid metabolism genes, acute treatment for 10 days with Kurozu was also examined.Results: Supplementation with resveratrol in HFD-fed mice did not ameliorate hepatic steatosis. Body weights were significantly lower in the CK + HFD and Resveratrol + HFD groups than in the control HFD group in middle age. No significant differences in all-cause mortality were observed following supplementation with CK or resveratrol. CK and resveratrol supplements significantly inhibited decreases in dehydroepiandrosterone sulphate serum levels at postnatal week 120. CK and resveratrol supplements did not affect the survival of mice. The ingestion of Kurozu for 10 days significantly elevated the expression levels of Sirt1, Pgc-1α, Lpin1, and Igfbp1 in the liver. Conclusion: These results suggest that ingesting CK may delay the onset of hepatic steatosis HFD feeding causes.Keywords: Kurozu, steatosis, Sirt1, Igfbp1, Lpin1, Pgc-1α, resveratrol

Do serum androgens influence blastocysts ploidy in karyotypically normal women?

ABSTRACTThe aim of the study was to determine if serum testosterone (T) and dehydroepiandrosterone (DHEAS) levels are a factor in determining increased risk for embryonic aneuploidy in karyotypically normal women undergoing in vitro fertilization (IVF) and preimplantation genetic testing screening for aneuploidy (PGT-A). This is a retrospective cohort study of IVF cycles with PGT-A performed during 2015–2016. A total of 256 cycles with 725 embryos were initially considered for inclusion. A total of 208 cycles and 595 embryos determined to be either euploid or aneuploid were included in the analysis. The mean age of women was 37.4 ± 4.4 years. There were 193 (32.44%) euploid, and 338 (56.81%) aneuploid blastocysts. Sixty-four (10.76%) had ‘no diagnosis’ after PGT-A. The 32 embryos with ‘no diagnosis’ after first PGT-A were biopsied again and after the second analysis, 7 were found to be euploid and 3 aneuploid. The remaining 32 embryos were not reanalyzed due to the lack of patients’ consent for the second biopsy. The relationship between embryo ploidy and levels of serum testosterone and dehydroepiandrosterone sulfate was assessed using ordinal multivariable regression analysis. The model, adjusted for both anti-Mullerian hormone (AMH) and age, showed no association between ploidy status and serum levels of the two hormones. We concluded that the serum levels of testosterone and DHEAS do not influence embryo ploidy in karyotypically normal women undergoing IVF.Abbreviations: T: testosterone; DHEAS: dehydroepiandrosterone; IVF: in vitro fertilization; PGT-A: preimplantation genetic testing screening for aneuploidy; AMH: anti-Mullerian hormone; FSH: follicle-stimulating hormone; LH: luteinizing hormone; E2: oestradiol; P: progesterone

The Effect of Soy Isoflavones on Steroid Metabolism.

Objective: This study is a post-hoc analysis of steroid hormones before and after administration of pharmacological doses of soy isoflavones in a large cohort of men and women from two independent studies. Isoflavones are reported to inhibit mineralo- and glucocorticoid hormone production as well as reproductive steroids in vivo and in vitro. We focused on cytochrome P450 17α-hydroxylase (CYP17A1) which catalyses the production of dehydroepiandrosterone (DHEA), in the androgen biosynthesis pathway to elucidate effects on sex steroids in vitro.Design and Setting: Effects of soy isoflavones on steroid levels in two studies comprising 400 patients were examined: 200 men (study 1; 3 months duration) and 200 postmenopausal women (study 2; 6 months duration), randomized to consume 15 g soy protein with 66 mg isoflavones (SPI) or 15 g soy protein alone without isoflavones (SP) daily. Effects of genistein and daidzein on steroid metabolism were determined in vitro, in HEK293 cells expressing CYP17A1 and in the human adrenocortical carcinoma H295R cell model.Results: SPI decreased serum dehydroepiandrosterone sulfate (DHEAS) levels in both men and women (P < 0.01), with decreased androstenedione (A4) (P < 0.01) in women not observed in men (P < 0.86). Cortisol, cortisone, 11-deoxycortisol, aldosterone, testosterone (T), or estradiol (E2) levels were unchanged. The dual hydroxylase and lyase activity of CYP17A1, which catalyses the biosynthesis of androgen precursors, and 3β-hydroxysteroid dehydrogenase (3βHSD2) were investigated in vitro. In transiently transfected HEK293 cells, only the lyase activity was inhibited by both genistein, 20% (P < 0.001) and daidzein, 58% (P < 0.0001). In forskolin-stimulated H295R cells DHEA production was decreased by daidzein (P < 0.05) and genistein, confirming inhibition of the lyase activity by the isoflavones.Conclusion: In Vivo clinical data suggested inhibition of CYP17A1 17,20 lyase within the adrenal in men and within the ovary and adrenal in females. This was confirmed in vitro with inhibition of the lyase activity by both genistein and daidzein. In addition, 3βHSD2 was inhibited perhaps accounting for decreased A4 levels observed in females. The decreased DHEAS and A4 levels together with the inhibition of the 17,20 lyase activity of CYP17A1, may impact production of androgens in clinical conditions associated with androgen excess.ISRCTN number: ISRCTN55827330ISRCTN number: ISRCTN 90604927

Inhibitory effects of Cheongsangbangpoong-tang on both inflammatory acne lesion and facial heat in patients with acne vulgaris: A double-blinded randomized controlled trial

ObjectivesTo investigate the inhibitory effects of an herbal formulation of Cheongsangbangpoong-tang (CBT) on inflammatory acne lesions as the control of the ‘Heat’ pattern. DesignA single center study. Randomized, placebo-controlled, parallel group, double-blind trial SettingFifty-six subjects, who had more than 10 acne inflammatory lesions each, were randomly allocated into the CBT or placebo groups and took 5 g CBT extract (CBT group) or 5 g placebo extract (control group), respectively, three times a day for 8 weeks. Pattern identification, change of the inflammatory and non-inflammatory acne lesions, temperature of the facial points, serum cortisol level, serum dehydroepiandrosterone-sulfate level, number rating scale, investigator global assessment (IGA), and severity score on the Korean acne grading system were measured. Main outcome measuremean change of the inflammatory acne lesions. ResultsAfter CBT/placebo administration, the percentage count of inflammatory lesions in subjects was significantly reduced in the CBT group when compared with the control group. The other outcomes showed no significant difference between the two groups. On pattern identification, subjects with the Wind-Heat pattern (風熱型, WHP) and Disharmony of the thoroughfare and conception vessels pattern (衝任不調型, DTCVP) tended show better effect than those with other patterns. ConclusionsCBT is a potential therapeutic agent for the treatment of acne vulgaris, linked to inhibition of inflammatory lesions and facial heat. Trial registrationCRiS (Clinical Research Information Service, Republic of Korea), KCT0001468. Registered 06 May 2015.

Involvement of serum dehydroepiandrosterone sulfate in erythropoietic activity

Purpose The aim of the present study was to determine how age-related decreases in serum dehydroepiandrosterone sulfate (DHEAS) levels affect various physiological processes. Methods We retrospectively reviewed the medical records of patients in whom serum DHEAS levels were measured in our department and assessed the relationships between serum DHEAS levels and various patient characteristics. Results Among the 149 patients included in our analysis (mean age: 52.7 ± 17.6 years, range: 15–84 years), 54 (36.2%) were men. Serum DHEAS levels inversely correlated with age in men (R = −0.810, p < .01) and to a lesser extent in women (R = −0.391, p < .01). Of note, there were significant positive associations between DHEAS levels and hemoglobin (R = 0.317, p ≤ .01) and hematocrit (R = 0.324, p ≤ .01) levels, which were observed in men, but not in women. Conclusions Our study suggests that reduced DHEAS secretion inhibits erythropoietic activity in aging men, perhaps owing to the erythropoietic androgenic actions of DHEAS. Importantly, it suggests that the age-associated decline in DHEAS secretion might decrease erythropoietic activity in aging men. It is also possible that the adrenal cortex, the source of DHEAS, is dysfunctional in anemic men.

Low levels of dehydroepiandrosterone sulfate are associated with the risk of developing cardiac autonomic dysfunction in elderly subjects.

To assess the relationships between serum dehydroepiandrosterone sulfate (DHEA-S) levels and heart rate variability (HRV) among different age groups. Forty-five healthy men were divided into 3 groups: young age (YA; 20-39 yrs; n = 15), middle age (MA; 40-59 yrs; n = 15) and old age (OA; ≥ 60 yrs; n = 15). Hemodynamic parameters, linear analyses of HRV and concentrations of cortisol and DHEA-S were measured at rest. The OA group presented a higher resting heart rate (84.3 ± 4.6 bpm) than the YA group (72.0 ± 4.4 bpm; p < 0.05). The YA group showed an attenuated variance of HRV (2235.1 ± 417.9 ms2) compared to the MA (1014.3 ± 265.2 ms2; p < 0.05) and OA (896.3 ± 274.1 ms2; p < 0.05) groups, respectively. The parasympathetic modulation of HRV was lower in both the MA (244.2 ± 58.0 ms2) and OA (172.8 ± 37.9 ms2) groups in comparison with the YA group (996.0 ± 255.4 ms2; p < 0.05), while serum DHEA-S levels were significantly lower in both the MA (91.2 ± 19.6 mg/dL) and OA (54.2 ± 17.7 mg/dL) groups compared to the YA group (240.0 ± 50.8 mg/dL; p < 0.05). A positive correlation between lower serum concentrations of DHEA-S and attenuated variance of HRV (r = 0.47, p = 0.031), as well as lower serum concentrations of DHEA-S and decreased parasympathetic modulation of HRV (r = 0.54, p = 0.010), were found. The present study demonstrated that the decline of plasma DHEA-S is associated with reduced cardiac autonomic modulation during the aging process.

Dehydroepiandrosterone sulfate, free testosterone, and sex hormone-binding globulin on susceptibility to attention-deficit/hyperactivity disorder

The neuroendocrine system may affect the pathophysiology of gender differences in attention deficit/hyperactivity disorder (ADHD). This study examines whether the relationships among dehydroepiandrosterone sulfate (DHEA-S), free testosterone, or sex hormone-binding globulin (SHBG) and ADHD presentations exhibit gender differences. A total of 113 boys and 35 girls with ADHD (all drug naïve) and 46 and 26 healthy control boys and girls, respectively, were recruited. Blood samples were obtained to measure the serum levels of DHEA-S, free testosterone, and SHBG in each child. The Swanson, Nolan, and Pelham Scale for ADHD Version IV (SNAP-IV) was used to evaluate behavioral symptoms and the Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV) and the Conners’ Continuous Performance Test (CPT) were utilized to assess neurocognitive functions. Patients with ADHD had lower DHEA-S levels than male and female healthy control subjects, and no significant differences were observed in free testosterone and SHBG levels between the patients and the controls. DHEA-S levels were negatively correlated with children’s impulsivity performance in the CPT. SHBG levels were negatively correlated with ADHD behavior symptoms among boys. Free testosterone levels were not significantly correlated with either ADHD clinical symptoms or neuropsychological functions. We propose that DHEA-S serves as a potential biomarker of ADHD and is consistently involved in the pathogenesis of ADHD in both boys and girls. SHBG may be involved in behaviors associated with ADHD in boys. Additional studies with basic scientific measures are warranted to elucidate the relationship between androgen hormones and clinical presentations of ADHD.

Circulating androgen levels before and after oophorectomy in premenopausal and postmenopausal women

Objective: This study aimed to determine the effect of oophorectomy on baseline serum levels of androgens and estrogens in premenopausal and postmenopausal women.Methods: Fourteen premenopausal and 10 postmenopausal women underwent total hysterectomy and bilateral oophorectomy for benign disease of the uterus. Serum levels of dehydroepiandrosterone sulfate (DHEAS), androstenedione (A), testosterone (T), dihydrotestosterone (DHT), 5α-androstane-3α,17β-diol-17β-glucuronide (3α-diol G), estrone (E1), estradiol (E2), and sex hormone-binding globulin (SHBG) were measured by highly specific immunoassays prior to surgery and 2 weeks afterward. Free T and free E2 were calculated. Differences were determined between preoperative (preop) and postoperative (postop) samples, and between premenopausal and postmenopausal women.Results: In premenopausal women, postop levels of total and free T, DHT, and total and free E2 decreased significantly from preop. Postop levels of DHEAS, A, 3α-diol G, and SHBG were decreased, but not significantly different from preop. In postmenopausal women, postop levels of total and free T and total and free E2 decreased significantly from preop, but there was little change in the other compounds. Significant differences in the mean change from baseline between premenopausal and postmenopausal women were observed only for E1 and total and free E2.Conclusion: The significant decrease in serum T in postmenopausal women following oophorectomy adds to the evidence that the postmenopausal ovary continues to produce T.

Does omalizumab treatment affect serum dehydroepiandrosterone sulphate levels in chronic idiopathic urticaria?

IntroductionIt is known that serum dehydroepiandrosterone sulphate (DHEA-S) levels are low in patients with chronic idiopathic urticaria.AimIn the study, the effect of the drug on the DHEA-S serum levels and its correlation with the remission and relapse times of the disease was investigated.Material and methodsFifty-seven patients with chronic idiopathic urticaria who were referred to our hospital and 20 healthy volunteers were included in the study. A subcutaneous injection of 300 mg omalizumab was administered to the patient group. Drug injections at this dose were completed (6 injections in total, one per month). Relations between serum DHEA-S levels and relapse rates, treatment response and remission duration of the patients and control group were investigated in the groups.ResultsMedian DHEA-S value before treatment was 116.3 (21.5–448.7) µg/dl; the median DHEA-S value measured after 3 months was 98.4 (10.0–410.0) µg/dl (p = 0.003). The median DHEA-S value before treatment was 123.1 (21.5–299.6) µg/dl when the initial and 3-month DHEA-S levels of the 34 complete remission patients were compared; after 3 months the value was 100.4 (23.1–301.9) µg/dl (p = 0.021).ConclusionsThis is the first study to investigate the effect of omalizumab treatment on DHEA-S levels in the treatment of chronic urticaria according to our literature review. The DHEA-S levels were found to be significantly lower after omalizumab therapy but not related to remission and relapse times.

Comparison of serum dehydroepiandrosterone sulfate, testosterone, and dihydrotestosterone levels in males with various degrees of acne vulgaris severity

Objective: This study compared the levels of dehydroepiandrosterone (DHEA) sulfate, testosterone, and dihydrotestosterone (DHT) in the serum of men with various degrees of severity grading of acne vulgaris. Methods: We conducted a cross-sectional analytic observational study and used the Combined Acne Severity Classification. Serum DHEA sulfate (DHEAS), testosterone, and DHT levels were measured by enzyme-linked immunosorbent assay. We recruited 63 males with acne vulgaris. Results: For mild, moderate, or severe acne, the mean serum level of DHEAS was 90.92, 153.54, and 166.67 ng/ml (P = 0.000); testosterone was 6.66, 8.11, and 8.97 ng/ml (P = 0.445); and DHT was 87.33, 111.72, and 124.71 (P = 0.01), respectively. Post hoc analysis showed significant differences for DHEAS and DHT serum levels. There were significant differences for DHEAS and DHT serum levels. Conclusion: There was no significant difference in serum testosterone levels between groups, although there was an increase in concentration by acne vulgaris severity.

The association between serum dehydroepiandrosterone sulfate (DHEAS) levels and job-related stress among female nurses.

BackgroundDehydroepiandrosterone sulfate (DHEAS) is an endogenous steroid hormone produced by the adrenal gland. DHEAS has been suggested to play a protective role against psychosocial stress. The aim of this study was to investigate the association between job-related stress and blood concentrations of DHEAS according to occupational stress factors among female nurses.MethodsA cross-sectional study was conducted among 118 premenopausal nurses from 4 departments (operating room, emergency room [ER], intensive care unit, and ward) of a university hospital. Participants were all rotating night shift workers who have worked for over a year and mean age of 33.5 ± 4.8 years. Data from structured questionnaires including the Korean Occupational Stress Score, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used.ResultsIn the high job-related stressor group, scores of BDI, BAI, and PSQI were significantly higher than low-stressor group. ER nurses had relatively more work-burden related stressors, but they had significantly lower levels of anxiety and depression than other groups. And, ER nurses showed higher levels of DHEAS than the other department nurses. The differences were significant (p = 0.003). Additionally, there was a statistically significant difference even after adjusting for factors that could affect level of DHEAS, such as age, body mass index, drinking, and physical activity (p = 0.039).ConclusionsThis result suggests the possibility that DHEAS may play a role as a marker of proper stress management. The capacity to secrete DHEAS is not simply due to workload or job stressor but could be determined depending on how individuals and groups deal with and resolve stress. Proper resolution of stress may affect positive hormone secretion.

A Prospective Observational Study Evaluating Sarcopenia By Using the Bioelectrical Impedance Analysis in Elderly Patients with Hematologic Malignancies

[Introduction] Sarcopenia is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Population-based studies reported that the prevalence of sarcopenia in Japanese healthy adults aged≥60 years was 8.5% among men and 8.0% among women. Sarcopenia was recently identified as a poor prognostic factor in patients with solid tumors. In cancer patients, sarcopenia is associated with treatment failure, chemotherapy toxicity, and a shorter time to tumor progression related to survival. In contrast to solid tumors, the clinical relevance of sarcopenia in hematologic malignancies is still unknown. The present study investigated the prevalence of sarcopenia based on the criteria of the Asian Working Group for Sarcopenia (AWGS) in elderly patients with hematologic malignancies.[Patients and Methods] We prospectively analyzed 56 elderly patients aged≥60 years with hematologic malignancies diagnosed at our institution between 2015 and 2018. Appendicular skeletal muscle mass (ASM) was measured at diagnosis by using multifrequency bioelectrical impedance analysis (BIA) (InBody 720). BIA is suitable for body composition monitoring in elderly patients as a fast, noninvasive, and convenient method. Skeletal muscle index (SMI) was defined as the ratio of ASM divided by height in square centimeters. We also evaluated physical function by using short physical performance buttery (SPPB). Sarcopenia was defined according to the AWGS algorithm, in which the patient has low muscle mass, and low muscle strength or low physical performance. Low muscle mass was defined as a skeletal muscle index (SMI: ASM/height2) of <7.0kg/m2 in men and <5.7kg/m2 in women. Pre-sarcopenia was defined as having only low muscle mass. Low muscle strength was defined as a handgrip strength of <26kg in men and <18kg in women; and low physical performance, as a gait speed of <0.8m/sec. The study protocol was approved by the Institutional Review Board of Yokohama Municipal Citizen's Hospital, and it was carried out in accordance with the Declaration of Helsinki.[Results] Median age at diagnosis was 77 years (60-93 years), with 34 males and 22 females. The diagnosis included non-Hodgkin lymphoma (NHL, n=36), multiple myeloma (MM, n=9), myelodysplastic syndrome (MDS, n=10), and acute myeloid leukemia (AML, n=1). The prevalence of low muscle mass (pre-sarcopenia) was 41% (14/34) in men and 77% (17/22) in women. The prevalence of low muscle strength was 35% (12/34) in men and 41% (9/22) in women. The prevalence of low physical performance status (Gait speed:<0.8m/sec) was 6% (2/34) in men and 9% (2/22) in women. The prevalence of sarcopenia based on a diagnosis of low muscle mass, low muscle strength, and low physical performance was 24% (8/34) in men and (8/22) 36% in women. The prevalence of low SPPB score (<10) was 9% (3/34) in men and 18% (4/22) in women. Among 36 NHL patients, the diagnosis included DLBCL (n=15), FL (n=10), MALT (n=3), SMZBCL (n=3), MCL (n=2), and others. The prevalence of sarcopenia was 25% (5/20) in men and 50% (8/16) in women. The mean age was 83 years in the sarcopenic group (n=13, 36%) and 73 years in the non-sarcopenic group (n=23, 64%) (p=0.0001). Sarcopenic patients displayed a similar level of serum albumin, LDH, sIL2-R, and BMI when compared with patients who were not sarcopenic. However, sarcopenic patients displayed significantly lower levels of serum dehydroepiandrosterone-sulfate (DHEA-S) and a higher CCI score than patients who were not sarcopenic. Sarcopenic patients failed to complete the treatment planned as compared with non-sarcopenic patients (p=0.001).[Conclusion] These results demonstrated that the prevalence of sarcopenia in elderly patients with hematologic malignancies is higher than that in the Japanese general elderly population. In particular, the prevalence of sarcopenia in female NHL patients is higher than that in male NHL patients. Several factors such as age, serum DHEA-S or comorbidities may affect the incidence of sarcopenia. Since our results are based on a small-sized analysis, further large prospective studies are warranted to verify this conclusion. DisclosuresNo relevant conflicts of interest to declare.

Association between serum activin A and metabolic syndrome in older adults: Potential of activin A as a biomarker of cardiometabolic disease.

Cardiovascular disease imposes substantial burdens of morbidity and mortality that increase with population aging. Estimating cardiometabolic risk accurately and expediently is challenging, and no single biomarker is satisfactory; hence, we investigated the potential of serum activin A for this purpose. Study data were collected from 433 community-dwelling adults age ≥53 years from Yilan County, Taiwan. Data included: demographics and medical history; physical measurements (blood pressure, body mass index, waist circumference); comprehensive functional assessments (frailty, cognitive function, depressive symptoms, nutritional status); fasting blood biochemistry (glucose, high-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, insulin-like growth factor-1, activin A, stratified into high, medium and low tertiles, and others); and dual-energy X-ray absorptiometry. Metabolic syndrome was considered a proxy for overall cardiometabolic risk. Subjects mean age was 69.3 ± 9.2 years, 48.3% were males. Compared to women, men had higher systolic blood pressure, education levels, relative appendicular skeletal muscle mass, waist circumference, physical activity, walking speed, free androgen index, and levels of serum uric acid, alanine aminotransferase, and dehydroepiandrosterone sulfate. High activin A was significantly associated with age, relative appendicular skeletal muscle mass in both gender, waist circumference in women, current alcohol drinking, hypertension, and Charlson Comorbidity Index. There were dose-dependent relationships (low to high) between serum activin A and frailty, cognitive impairment, malnutrition, metabolic syndrome, uric acid, and high-sensitivity C-reactive protein. Logistic regression analyses showed older age, serum uric acid, and metabolic syndrome were significantly associated with medium and high activin-A status, whereas, skeletal muscle mass, insulin-like growth factor-1 and dehydroepiandrosterone sulphate were associated with high, but not medium, serum activin A. This discovery of a dose-dependent association between serum activin A levels, age, and metabolic syndrome, suggests activin A may be a biomarker of overall cardiometabolic risk; however, further studies are needed to evaluate its potential applications in assessing and managing cardiometabolic risk.

Association between Body Mass Index and Serum Dehydroepiandrosterone Sulfate Level in 8-Year-Old Girls.

BackgroundAdiposity may play a role as a potential trigger for adrenarche. The purpose of this study was to evaluate the association between body mass index (BMI) and serum dehydroepiandrosterone sulfate (DHEAS) level.MethodsThe medical records of 8-year-old girls who presented to our clinic between 2014 and 2016 with concerns regarding pubertal changes were retrospectively reviewed. The 192 girls were divided into two groups depending on activation of the hypothalamic-pituitary-gonadal (HPG) axis. Group I included 77 subjects with a breast Tanner stage 1 with unknown HPG axis or thelarche without activated HPG axis. Group II included 115 subjects with activated HPG axis. Serum DHEAS level ≥1.1 μmol/L was regarded as biochemical adrenarche.ResultsBased on correlation analyses, BMI standard deviation score (SDS) was positively correlated with height SDS, bone age divided by chronological age (BA/CA), and DHEAS level in all subjects (r=0.269, r=0.270, r=0.298; all P<0.001, respectively). BMI SDS was negatively correlated with peak luteinizing hormone level in group II (r=−0.236, P=0.011). Based on multiple linear regression analyses, BMI SDS was associated with serum DHEAS level in all subjects (β=0.280, P<0.001), group I (β=0.415, P=0.001), and group II (β=0.206, P=0.030). DHEAS level was also associated with BA/CA in all subjects (β=0.402, P<0.001), group I (β=0.494, P<0.001), and group II (β=0.347, P<0.001).ConclusionBMI SDS was associated with DHEAS level, which was associated with BA/CA. Childhood obesity may influence the development of adrenarche, which may contribute to advanced skeletal maturation.

PRIMARY ALDOSTERONISM IN YOUNG PATIENT WITH RECURRENT RESISTANT HYPERTENSION AFTER SOLITARY ADRENAL ADENOMA SURGICAL RESECTION

Objective: the diagnostic workup of resistant hypertension in young patients the therapeutic approach of patients with primary aldosteronism due to adrenal adenoma and contra-lateral adrenal hyperplasia the diagnostic workup and reevaluation of aldosteronism recurrence after initial surgical treatment the correlation between recurrent resistant hypertension and primary aldosteronism recurrence. Design and method: A 34-year-old male was referred to our specialized department for second-degree arterial hypertension (mean readings 170/110 mmHg). The physical examination was normal, except his 31 kg/m2 Body Mass Index. The ECG and cardiac ultrasound had normal findings. Basic laboratory studies were in physiological range. Secondary hypertension diagnostic workup was decided and initial treatment with two neutral antihypertensive agents. Specific hormonal profile revealed a plasma aldosterone(PA) level of 237.9 pg/ml and a plasma renin activity(PRA) of 0,23ng/ml/h, resulting in a pathological plasma aldosterone/plasma renin activity(PA/PRA) ratio. The saline suppression test revealed a plasma renin activity of 0.02 ng/ml/h and a high plasma aldosterone level of 20,29 pg/ml. The serum levels of dehydroepiandrosterone sulfate, adrenocorticotropin, and cortisol were normal. The suprarenal magnetic resonance imaging illustrated a 46,3 × 31 mm left adrenal adenoma and contralateral adrenal hyperplasia. A surgical intervention was performed with adrenal adenoma enucleation.Results: Postoperatively, the patient remained normotensive for about 14 months. He presented thereafter with a recurrence of resistant hypertension. New basic and hormonal laboratory studies revealed plasma renin activity levels of 0,4 ng/ml/h and plasma aldosterone levels of 381 pg/ml. After saline suppression test, plasma aldosterone levels remained high (163pg/ml). The magnetic resonance imaging illustrated a small left adrenal adenoma of 11 mm and constant right adrenal hyperplasia. The patient was initially treated with 200 mg eplerenone/ day with subsequently dose adjustment to 100 mg/day resulting in mean blood pressure readings of 135/90mmHg and no concurrent hyperkalemia. Conclusions: Primary hyperaldosteronism remains a challenging diagnosis. Unilateral adrenal hyperplasia is statistically rare, as well as the coexistence of contralateral big size adrenal adenoma. In young patients presenting with adrenal adenomas (especially big sized) and concurrent pathological hormonal profile, the surgical treatment is probably required, without however excluding new hormonal control for secondary hypertension in case of hypertension recurrence.

Association of serum testosterone and dehydroepiandrosterone sulfate with rheumatoid arthritis: a case control study.

BackgroundIt is supposed that hypoandrogenism may be involved in the pathogenesis of rheumatoid arthritis (RA). Testosterone and dehydroepiandrosterone sulfate (DHEAs) levels decrease in body fluids of patients with RA.ObjectiveThe aim of this study was to determine the association of serum testosterone and DHEAs with RA.MethodsThis case-control study was conducted on 59 patients with RA and 61 healthy gender- and age-matched controls at Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Serum free testosterone and DHEAs levels were measured and compared between two groups. Serum testosterone levels lower than 0.029 ng/ml in females and 2.49 ng/ml in males were considered as abnormal. DHEAs levels lower than 18.9 μg/dl in females and 88.9 μg/dl in males were considered as abnormal. Data were analyzed using independent sample T-test, Chi-square test, and logistic regression analysis by SPSS software, version 19.ResultsThe mean testosterone level in females of the control group was significantly higher than females in the case group. The mean DHEAs in the control group was significantly higher than the case group. Abnormal testosterone and DHEAs level in the case group was significantly higher than the control group. Logistic regression analysis showed independent association only between DHEAs levels and RA, after adjusting for age and gender (OR: 0.966, 95% CI: 0.953–0.979; p<0.001).ConclusionWith regard to the results, abnormal testosterone and DHEAs level in patients with RA was significantly higher than the control group. This shows the anti-inflammatory effects of gonadal and adrenal androgens in RA.

The effect of resistant dextrin as a prebiotic on metabolic parameters and androgen level in women with polycystic ovarian syndrome: a randomized, triple-blind, controlled, clinical trial.

Polycystic ovary syndrome (PCOS) is one of the most common abnormalities in women of reproductive age that can lead to a variety of metabolic and reproductive disorders. Studies reveal that a healthy diet is the most effective way for treating the risk factors associated with metabolic disorders and place greater emphasis on the consumption of prebiotic foods. The present study aims to determine the effect of resistant Dextrin on metabolic parameters, including lipid profile, fasting blood glucose (FBS) and high sensitivity C-reactive protein (hsCRP), and androgen levels, including serum levels of dehydroepiandrosterone sulfate (DHEA-S) and free testosterone, as the primary outcomes, and manifestations of PCOS including menstrual cycle irregularity and hirsutism, as the secondary outcomes. This randomized, controlled, triple-blind, clinical trial was conducted on 62 women aged 18-45 in Tabriz, Iran, in 2016-2017. The participants were divided into a prebiotic group and a placebo group using block randomization. The prebiotic group consumed 20g of resistant dextrin dissolved in a glass of water and the placebo group 20g of maltodextrin also dissolved in a glass of water on a daily basis for 3months. To measure the serum lipid profile, FBS, hsCRP, DHEA-S and free testosterone before and 3months after the intervention, 5-ml blood samples were collected from the participants and analyzed using the ELISA method. The Ferriman-Gallwey scale for assessing hirsutism and a checklist for assessing menstrual cycle characteristics were completed before and 3months after the intervention. A general linear model was used to analyze the data. No statistically significant differences were observed between the two groups in terms of sociodemographic characteristics and baseline values. 3months after the intervention, based on the ANCOVA and after adjusting for the baseline values, the mean serum levels of LDL-C (adjusted mean difference = - 29.79; 95% CI = - 43.37 to - 16.21; P < 0.001), triglyceride (AMD = - 38.50; 95% CI = - 59.73 to - 17.28; P = 0.001), total cholesterol (AMD = - 29.98; 95% CI = - 40.14 to - 19.82; P < 0.001), FBS (AMD = - 11.24; 95% CI = - 15.43 to - 7.06; P < 0.001), hsCRP (AMD = - 1.75; 95% CI = - 2.92 to - 0.57; P = 0.004), DHEA-S (AMD = - 0.7; 95% CI = - 1.34 to - 0.13; P = 0.017) and free testosterone (AMD = - 0.32; 95% CI = - 0.56 to - 0.08; P = 0.010) revealed a statistically significant decrease in the intervention group compared to the placebo group, while the mean serum HDL-C showed a statistically significant increase in this group compared to the placebo group (AMD = 5.82; 95% CI = 2.27-9.37; P = 0.002). 3months after the intervention, there was a significant difference between the two groups in terms of menstrual cycle intervals and hirsutism (P < 0.001). Resistant dextrin consumption can regulate metabolic parameters and androgen levels and manifestations including hirsutism and menstrual cycle irregularity in women with PCOS.

Maternal serum dehydroepiandrosterone sulfate as a predictor of labor inhibition in preterm labor

Objective The aim of this study was to assess the relationship between endogenous serum dehydroepiandrosterone sulfate (DHEA-S) levels and success of labor inhibition in preterm labor. Background Preterm birth is the leading cause of neonatal mortality and morbidity. Patients and methods This prospective trial included 43 pregnant women with preterm labor. Labor inhibition was achieved using calcium channel blockers such as nifedipine (epilat 10-mg capsules at a dose of 10 mg orally every 20 min until uterine contractions are inhibited and maintained regularly by epilat retard tablets every 8 h). Serum DHEA-S levels were measured twice, the first just before labor inhibition by tocolytic drugs, and the second sample was obtained after 48 h from starting tocolytic drugs. The levels were evaluated by radioimmunoassay. Ultrasound assessment of the cervix was also carried out. Results There was a highly significant statistical difference between cases delivered at full term (n = 29) and cases delivered preterm (n = 14) regarding post-tocolytic DHEA-S levels (P = 0.0009). There was a significant statistical difference in pretocolytic levels of DHEA-S in cases that delivered preterm and failed to respond to tocolytic therapy. The cutoff value of pretocolytic DHEA-S was greater than or equal to 94 μg/dl, at which tocolytic therapy failed. Conclusion Maternal serum DHEA-S concentrations were normal in patients with successful tocolysis compared with elevated levels in patients with failed tocolysis who experienced preterm delivery. Elevated serum DHEA-S levels of more than 94 μg/dl could be used to predict failure of labor inhibition in preterm labor.