Sex hormones and DHEA-SO4 in relation to ischemic heart disease mortality in diabetic subjects - The Wisconsin Epidemiologic Study of Diabetic Retinopathy
Sex hormones and DHEA-SO4 in relation to ischemic heart disease mortality in diabetic subjects - The Wisconsin Epidemiologic Study of Diabetic Retinopathy
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DOI：
10.2337/diacare.19.10.1045
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发表时间：
1996-10-01
期刊：
影响因子：
16.2
通讯作者：
Klein, R
中科院分区：
文献类型：
--
作者：
Haffner, SM;Moss, SE;Klein, R
目的：性激素与脂蛋白、葡萄糖和胰岛素代谢的改变有关，但在糖尿病患者中，性激素和脱氢表雄酮硫酸盐(DHEA-SO4)与缺血性心脏病(IHD)的关系研究很少。研究设计和方法-我们研究了总睾酮和游离睾酮、性激素结合球蛋白、雌酮、雌二醇、在威斯康星州糖尿病视网膜病变流行病学研究(WESDR)中，采用匹配的糖尿病受试者对照设计(每个糖尿病受试者两个对照受试者)，将DHEA-SO4与老年糖尿病受试者的5年IHD死亡率进行相关性研究。结果：在男性(n=123)中，性激素或DHEA-SO4均未显著预测IHD死亡率。在女性(n=120)中，较低水平的DHEA-SO4(P<；0.01)和总睾酮(P=0.07)可预测IHD死亡率。在调整了糖尿病病程、糖化血红蛋白、利尿剂的使用和血肌酐后，这些结果基本上没有变化，这些都是西医大学附属医院IHD死亡率的主要预测因素。在女性IHD的糖尿病患者中发现较低的睾酮水平与危险因素的数据相反，这表明雄激素活性增加可能与更糟糕的IHD危险因素相关。结论--这项研究表明，性激素和DHEA-SO4的变化不太可能解释糖尿病患者IHD死亡率变化的主要部分。
OBJECTIVE - Sex hormones are associated with atherogenic changes in lipoproteins and changes in glucose and insulin metabolism, yet few data are available on the relationship of sex hormones and dehydroepiandrosterone sulfate (DHEA-SO4) to ischemic heart disease (IHD) in diabetic subjects, a group with very high levels of IHD.RESEARCH DESIGN AND METHODS - We examined the relation of total and free testosterone, sex hormone binding globulin, estrone, estradiol, and DHEA-SO4 to the 5-year IHD mortality in the older-onset diabetic subjects in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) in a matched diabetic subject-control design (two control subjects for every diabetic subject).RESULTS - In men (n = 123), none of the sex hormones or DHEA-SO4 significantly predicted IHD mortality. In women (n = 120), lower levels of DHEA-SO4 (P < 0.01) and total testosterone (P = 0.07) predicted IHD mortality. These results were essentially unchanged after adjustment for duration of diabetes, GHb, diuretic use, and serum creatinine, which are major predictors of IHD mortality in the WESDR. Finding lower testosterone levels in diabetic subjects of IHD in women is contrary to data on risk factors, which suggests that increased androgen activity may be associated with worse IHD risk factors.CONCLUSIONS - This study suggests that alterations in sex hormones and DHEA-SO4 are unlikely to explain a major proportion of the variation in IHD mortality in diabetic subjects.