DHEA-S production capacity in relation to perceived prolonged stress

February 21, 2022 Taylor 0 Comments

We and other research groups have previously described that levels of the anabolic hormone dehydroepiandrosterone sulfate (DHEA-S) are lowered in individuals who report prolonged stress. We have also shown that the DHEA-S production capacity during acute stress is attenuated in individuals reporting high prolonged stress. This study aimed to further investigate the DHEA and DHEA-S production capacity in relation to prolonged stress. Eighty-one healthy participants in the age 20-50 years old were included in the study and divided into a low stress (n = 45) and a high stress group (n = 36) according their response to a single question regarding perceived stress during the preceding month.

They underwent the Trier Social Stress Test while blood samples were drawn before, during and after the stress test. The concentration of DHEA, DHEA-S, cortisol and ACTH was measured. The results showed that the high stress group exhibited a significantly lower response of DHEA-S (40% lower) than the low stress group, while DHEA, cortisol and ACTH responses did not differ between the groups. Reduced DHEA-S production may constitute one of the links between stress and poor health.

Circulating DHEA–S levels and major cardiovascular outcomes in chronic Chagas cardiomyopathy: A prospective cohort study

Objective: To analyze the association of circulating dehydroepiandrosterone sulfate (DHEA-S) levels with cardiovascular outcomes in patients with chronic Chagas cardiomyopathy (CCM) diagnosis.

Background: DHEA-S is among the main endogenous steroid hormones. Some studies have suggested a relevant role of this hormone in infections and the setting of CCM. Nevertheless, no study has evaluated the prognostic role of DHEA-S in CCM patients.

Methods: Prospective cohort study. Patients with CCM and reduced ejection fraction were included. We explored the association of DHEA-S levels with NT-proBNP levels and echocardiographic variables using linear regression models. Next, by using Cox Proportional Hazard models, we examined whether levels of DHEA-S could predict a composite outcome (CO) including all-cause mortality, cardiac transplantation, and implantation of a left ventricular assist device (LVAD).

Results: Seventy-four patients were included (59% males, median age: 64 years). After adjustment for confounding factors, high DHEA-S levels were associated with better LVEF, lower left atrium volume, end-systolic volume of the left ventricle and lower NT-proBNP levels. 43% of patients experienced the CO during a median follow-up of 40 months. Increased levels of DHEA-S were associated with a lower risk of developing the CO (HR 0.43; 95%CI 0.21-0.86). Finally, adding DHEA-S to the multivariate model did not improve the prediction of the CO, but substituting NT-proBNP in the model with DHEA-S showed similar performance.

Conclusions: In patients with CCM, higher DHEA-S levels were associated with lower mortality, heart transplantation, and LVAD implantation. Further larger studies are required to confirm our results and assess causality.

Comparative Profiling of Salivary Cortisol and Salivary DHEA–S Among Healthy Pregnant and Non-Pregnant Women

During pregnancy, circulatory cortisol levels increase, remaining steady over the second-third trimester. In contrast, profile of salivary cortisol during pregnancy is debatable, more influenced by factors like time of sample collection in the day. Circulatory DHEA-S decrease by at least 50% over the second-third trimester of pregnancy. However, profile of salivary DHEA-S is unclear. Objective was to determine changes in salivary cortisol and DHEA-S in healthy pregnant women, compared to non-pregnant women during late morning-early afternoon sampling to avoid fluctuations associated with other times.

Pregnant women in their second-third trimester prospectively (n=500) and non-pregnant women (n=133) were enrolled in study with informed consent. Live birth outcome with no pregnancy complications and≥2.5 Kg infant birth weight were included. Concentrations of salivary cortisol and DHEA-S were determined through ELISA assays. Compared to non-pregnant women, pregnant women demonstrated significant increases in salivary cortisol [median (interquartile range)=4.2 (5.1) nmol/l vs. 17.2 (13.9) nmol/l, p<0.001] and salivary DHEA-S median (interquartile range)=2.7 (2.9) nmol/l vs. 3.8 (3.2) nmol/l, p<0.001). Consistently, quartile scores representing higher levels of salivary cortisol and DHEA-S concentrations demonstrated significant association with pregnancy.

Quartile scores representing higher salivary cortisol/DHEA-S ratio demonstrated significant association with pregnancy. Study suggests the indicated time range of saliva sampling might best parallel the established profile of circulatory cortisol in pregnant women. However, unlike cortisol, study indicates that the salivary DHEA-S profile is distinct from the well-known profile of circulatory DHEA-S during pregnancy. A combinatorial approach involving both salivary and circulatory compartments could provide comprehensive picture of DHEA-S and hypothalamus-pituitary-adrenal axis during pregnancy.

Comparative profiling of prenatal cortisol and DHEA–S among pregnant women with poor birth outcome and pregnant women with normal birth outcome

Context: Cortisol and dehydroepiandrosterone-sulfate (DHEA-S) are indispensable hormones for normal pregnancy. It is unclear if these hormones, specifically DHEA-S can offer value for predicting poor birth outcome.

Objective: To compare prenatal cortisol and DHEA-S levels among pregnant women with normal or poor birth outcome.

Design-patients: Plasma and saliva were collected prospectively from women in second-third trimester of pregnancy. Women with normal birth outcome (NBO), (n=501) included live birth, no pregnancy complications and ≥ 2.5Kg infant birth weight. Women with poor birth outcome included adverse birth (ABO), (n=50) or low birth weight outcome (LBW), (n=147).

Measurements: ELISA was performed to measure hormone concentrations in plasma and saliva.

Results: Circulatory-DHEA-S levels in pregnant women with ABO were higher than women with NBO (p=0.043). Among ABO, only stillbirth cases demonstrated significant increase in circulatory-DHEA-S levels (p=0.006). Circulatory and salivary cortisol/DHEA-S ratio was lower among women with stillbirth (p=0.004) and ABO outcome (p=0.043) respectively compared to women with NBO. Consistently, increased odds of ABO were observed in pregnant women with highest circulatory-DHEA-S levels (odds ratio quartile score 1 vs 4, 2.79, p=0.027) and lowest salivary cortisol/DHEA-S ratio (score 4 vs 2, 2.83, p=0.025). Increased odds of stillbirth outcome were observed in pregnant women with highest circulatory-DHEA-S levels (odds ratio quartile score 1 vs 4, 8.47, p=0.046) and lowest circulatory cortisol/DHEA-S ratio (score 4 vs 1, 4.803, p=0.048). Associations remained significant after adjusting for confounders. Women with LBW did not demonstrate significant changes in cortisol or DHEA-S levels.

Conclusion: Prenatal measurement of DHEA-S or cortisol/DHEA-S ratio may offer significant value for predicting adverse birth, specifically stillbirth outcome.

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Is there an association of cortisol, DHEA–S and cortisol/DHEA–S ratio with obesity and selected metabolic parameters?

A growing problem of obesity observed worldwide results in an increased interest of its pathogenesis. One hypothesis is the association between hypothalamus-pituitary-adrenal axis and obesity.

Aim: The aim of this study was to assess cortisol and DHEA-S secretion and their association with body mass and other selected metabolic parameters.

Materials and methods: 91 obese patients and 50 non-obese controls were recruited. The obese group was further subdivided into metabolically healthy and metabolically unhealthy individuals. Blood cortisol was assessed in the morning and in the evening. Other laboratory and anthropometric parameters were also checked. In the obese group, DHEA-S was measured additionally and cortisol/DHEAS ratio calculated.

Results: Morning and evening cortisol concentrations were comparable in two studied groups (p>0.05). The only significant difference was the morning to evening cortisol amplitude (212.97±140.24 in the obese vs 171.81±94.00 in the non-obese, p=0.04). Cortisol secretion parameters were not correlated with age, body mass or BMI when whole group was analyzed. In the obese group morning cortisol was negatively correlated with body mass (r=-0.29, p=0.01) and cortisol amplitude with body mass (r=-0.26, p=0.02) and BMI (r=-0.22, p=0.04). DHEA-S was negatively correlated with fasting glucose (r=-0,48 p<0.01) and HOMA-IR (r=-0.26 p =0.03) in the obese group, although it was no longer significant after correcting for age.

Conclusions: There is no strong association between cortisol secretion parameters or DHEA-S and obesity; however, some alterations can be observed with increasing body mass. Further studies should explain their potential role in obesity pathogenesis.