The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on August 27, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(12):1268-1274; doi:10.1093/gerona/glp129
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Trajectories of Dehydroepiandrosterone Sulfate Predict Mortality in Older Adults: The Cardiovascular Health Study
1 Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia
2 Department of Biostatistics, University of Washington, Seattle
3 Division of Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia
4 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
5 Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania
Address correspondence to Dr. Anne R. Cappola, MD, ScM, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, 764 CRB, 415 Curie Boulevard, Philadelphia, PA 19104. Email: acappola{at}mail.med.upenn.edu
 |
Abstract |
|---|
Background: Dehydroepiandrosterone sulfate (DHEAS) has been proposed as an antiaging hormone, but its importance is unclear. Assessment of an individual’s ability to maintain a DHEAS set point, through examination of multiple DHEAS levels over time, may provide insight into biologic aging.
Methods: Using Cox proportional hazard models, we examined the relationship between DHEAS trajectory patterns and all-cause death in 950 individuals aged 
65 years who were enrolled in the Cardiovascular Health Study and had DHEAS levels measured at three to six time points.
Results: Overall, there was a slight decline in DHEAS levels over time (–0.013 µg/mL/y). Three trajectory components were examined: slope, variability, and baseline DHEAS. When examined individually, a steep decline or extreme variability in DHEAS levels was associated with higher mortality (p < .001 for each), whereas baseline DHEAS level was not. In adjusted models including all three components, steep decline (hazard ratio [HR] 1.75, confidence interval [CI] 1.32–2.33) and extreme variability (HR 1.89, CI 1.47–2.43) remained significant predictors of mortality, whereas baseline DHEAS level remained unpredictive of mortality (HR 0.97 per standard deviation, CI 0.88–1.07). The effect of trajectory pattern was more pronounced in men than in women. Individuals with both a steep decline and extreme variability in DHEAS levels had a significantly higher death rate than those with neither pattern (141 vs 48 deaths per 1,000 person-years, p < .001).
Conclusions: Our data show significant heterogeneity in the individual trajectories of DHEAS levels and suggest that these trajectories provide important biologic information about the rate of aging, whereas the DHEAS level itself does not.
Keywords DHEA; DHEAS; Mortality; Aging; Elderly
Received: April 29, 2009; Accepted: July 27, 2009