A longitudinal study of dehydroepiandrosterone sulphate (DHEAS) change in older men and women: the Rancho Bernardo Study.
A longitudinal study of dehydroepiandrosterone sulphate (DHEAS) change in older men and women: the Rancho Bernardo Study.
复制标题
老年男性和女性硫酸脱氢表雄酮 (DHEAS) 变化的纵向研究：兰乔贝尔纳多研究。
DOI：
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发表时间：
2004
影响因子：
5.8
通讯作者：
R. Platt
中科院分区：
文献类型：
--
作者：
C. Tannenbaum;E. Barrett;G. Laughlin;R. Platt
目的
研究老年社区居民内源性硫酸脱氢表雄酮（DHEAS）水平变化的年龄相关和性别特异性比率和决定因素，并考虑回归均值。
设计
来自Rancho Bernardo，加州，USA的前瞻性队列研究。
方法
在基线和10-14年后从242名男性和207名绝经后女性（年龄范围，60-77岁）中收集DHEAS的血浆，他们没有接受激素治疗或皮质类固醇。根据四种不同的变化定义计算DHEAS的性别相关和性别特异性变化：绝对变化、年度百分比变化、超过基线10%的变化和超过统计回归平均值预期的变化。使用回归分析评估DHEAS变化的决定因素。
结果
男性基线DHEAS水平高于女性（年龄校正平均值，1.37+/-0.73 microg/ml（3.72+/-1.98 micromol/l）vs 0.73+/-0.48 microg/ml（1.98+/-1.30微摩尔/升），P<0.0001），在男性中观察到更明显的下降（-4.0%/年）与女性（-2.1%/年; P<0.001）相比。根据10%的变化定义，大约28%的女性和5%的男性的DHEAS水平增加或保持不变。当回归到平均人为因素时，只有15%的女性和5%的男性表现出DHEAS的真实增加。在两种性别中，基线DHEAS水平占DHEAS绝对变化随时间变化的四分之三，基线水平越高，损失越大。在单变量模型中，性别、基线体重、年龄和吸烟状况与DHEAS变化显著相关;在多变量分析中，只有性别与DHEAS变化独立相关，男性的年下降幅度大于女性（估计系数=0.006，P=0.008）。
结论
在该样本中，超过30%的DHEAS观察到的变化可归因于回归平均值。DHEAS水平的变化，和性别差异，潜在的潜在机制进行了讨论。
OBJECTIVE
To examine the age-related and sex-specific rates and determinants of change in endogenous dehydroepiandrosterone sulphate (DHEAS) levels in older community-dwelling adults, taking into account regression to the mean.
DESIGN
Prospective cohort study from Rancho Bernardo, California, USA.
METHODS
Plasma for DHEAS was collected at baseline and 10-14 years later from 242 men and 207 postmenopausal women (age range, 60-77 years), who were not taking hormone therapy or corticosteroids. Age-related and sex-specific changes in DHEAS were calculated according to four different definitions of change: absolute change, annual percentage change, change exceeding 10% of baseline and change exceeding that expected from statistical regression to the mean. Determinants of DHEAS change were assessed using regression analyses.
RESULTS
Baseline DHEAS levels were higher for men than women (age-adjusted means, 1.37+/-0.73 microg/ml (3.72+/-1.98 micromol/l) vs 0.73+/-0.48 microg/ml (1.98+/-1.30 micromol/l) respectively, P<0.0001), with more pronounced declines observed in men (-4.0%/year) compared with women (-2.1%/year; P<0.001). Some 28% of women and 5% of men had DHEAS levels that increased or stayed the same according to a 10% definition of change. When regression to the mean artifact was accounted for, only 15% of women and 5% of men showed true increases in DHEAS. In both sexes, baseline DHEAS levels accounted for three-quarters of the variability in absolute DHEAS change over time, with higher baseline levels resulting in greater loss. Sex, baseline weight, age and smoking status were significantly associated with DHEAS change in univariate models; only sex remained independently associated with DHEAS change in multivariate analyses, with men showing greater annual declines than women (estimated coefficient=0.006, P=0.008).
CONCLUSION
In this sample, over 30% of the observed changes in DHEAS could be attributed to regression to the mean. Potential underlying mechanisms of change in DHEAS levels, and sex differences, are discussed.
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