Association between Plasma Dehydroepiandrosterone Sulfate and Carotid Intima-Media Thickness among Male and Female Patients with End-Stage Renal Disease on Hemodialysis

Cardiorenal Med. 2020;10(1):61-68. doi: 10.1159/000504083. Epub 2019 Nov 26.

Abstract

Background and aim: Serum dehydroepiandrosterone sulfate (DHEA-S) is known to be lower in chronic kidney disease (CKD) patients and in those with cardiac disease, and correlates with a poor cardiovascular outcome. This study aimed to assess the correlation between DHEA-S and carotid intima-media thickness (CIMT) as a predictor of cardiovascular disease in hemodialysis (HD) patients.

Methods: A total of 88 HD patients were included in this cross-sectional study. They included 53 male (group I) and 35 female patients (group II). In addition to conventional history taking, clinical examination, and routine laboratory investigations, serum DHEA-S and CIMT were measured for all patients. CIMT was measured using B-mode ultrasonography, and the mean of maximum CIMT was recorded. The 2 patient groups were further classified according to the level of DHEA-S. The correlation between serum DHEA-S and CIMT was studied.

Results: In male patients, CIMT and age were significantly higher in the group with low DHEA-S level (p = 0.003 and 0.001, respectively), while there was no significant difference in both parameters in females. A higher percentage of HCV-positive patients is present in the male group with low DHEA-S level (p = 0.009). Serum DHEA-S is significantly negatively correlated with CIMT in males (p = 0.003) but not in females, and has a significant negative correlation to age in both genders (p = 0.001 and 0.04, respectively).

Conclusion: Endocrinal disturbance representing as lower serum DHEA-S is associated with increased CIMT, which is considered a predictor of cardiovascular disease in male HD patients, although it is largely explained by advancing age.

Keywords: Cardiovascular disease; Carotid intima-media thickness; DHEA-S; Dehydroepiandrosterone sulfate; Hemodialysis.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology
  • Carotid Intima-Media Thickness / instrumentation
  • Carotid Intima-Media Thickness / statistics & numerical data*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Dehydroepiandrosterone Sulfate / blood*
  • Female
  • Hepatitis C / complications
  • Hepatitis C / epidemiology
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / metabolism*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Renal Dialysis / methods*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / mortality
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Assessment
  • Serum Albumin / analysis
  • Ultrasonography / methods

Substances

  • Serum Albumin
  • Dehydroepiandrosterone Sulfate