Serum Dehydroepiandrosterone Sulfate and Risk for Type 2 Diabetes in Older Men and Women: The Pro.V.A Study

A large body of clinical data suggests the importance of endogenous sex hormones in the pathogenesis of diabetes, but very little is known about the possible relationship between dehydroepiandrosterone sulfate (DHEAS) and diabetes, particularly in the elderly. We aimed, therefore, to examine whether high serum levels of DHEAS have any protective effects on the incidence of type 2 diabetes and to elucidate the possible role of gender in a cohort of older subjects. We followed 1258 community -dwelling subjects aged >= 65 years without type 2 diabetes who belonged to the Progetto Veneto Anziani (Pro.V.A.) for 4.4 +/- 1.2 years. DHEAS were measured at baseline and categorized into gender -specific tertiles. The incidence of type 2 diabetes was diagnosed in cases of fasting plasma glucose above 7.0 nmol/L, glycated hemoglobin >= 26.5%, use of glucose-lowering drugs or a 2 -hour postload blood sugar level :211.1 nmolll, during the follow-up period. Although no significant differences in potential risk factors for diabetes were apparent across DHEAS tertiles at the baseline in either gender, when those with lower DHEAS were taken for reference, Cox regression analysis showed that males in the highest DHEAS tertile had lower risks for being diagnosed with diabetes during the follow up (HR=0.23; 95% Cl' 0.11-0.51; p<0.0001), whereas no significant differences emerged across DHEAS tertiles for females or for the sample as a whole. Higher serum DHEAS levels revealed a significant protective effect against the onset of type 2 diabetes in older men but not in older women, confirming different sensitivities of type 2 diabetes to DHEAS between genders.