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Reduced DHEA levels in men associated with greater risk of cardiovascular disease

Reduced DHEA levels in men associated with greater risk of cardiovascular disease

Friday, June 29, 2012. The Endocrine Society's 94th Annual Meeting held in Houston was the site of a presentation on June 23, 2012 of the finding of a protective effect for higher levels of the steroid hormone dehydroepiandrosterone (DHEA) against the risk of cardiovascular events in men. DHEA, produced by the adrenal glands, acts a precursor to the hormones estradiol and testosterone. While some research findings have suggested an association between increased DHEA levels and a reduction in heart disease, the majority of the studies involving DHEA have been small and results have not always been conclusive.

Åsa Tivesten, MD, PhD of the University of Gothenburg in Sweden and colleagues analyzed data from 2,416 men between the ages of 69 and 81 years enrolled in the Osteoporotic Fractures in Men Sweden study, which was designed to evaluate risk factors for several diseases. Blood samples obtained upon enrollment were analyzed for DHEA and DHEA sulfate (DHEA-S)--the sulfate ester of DHEA which is the form of the hormone that occurs predominantly in the blood.

Over a five year follow-up period, 485 cases of fatal or nonfatal cardiovascular events were documented. Having a higher serum DHEA was associated with a lower risk of cardiovascular events, as was having a higher level of DHEA-S. Men whose DHEA-S was among the lowest one-fourth participants had a 25 percent higher risk of events compared to the rest of the subjects, and those whose levels of both DHEA and DHEA-S were among the lowest fourth had a 34 percent higher risk of any major cardiovascular event, and a 41 percent higher risk of a cerebrovascular event compared to the remainder of the group.

"Our findings may be the result of DHEA-S being protective, or that lower DHEA-S level is a marker for poor general health," stated Dr Tivesten, who is an associate professor at the University of Gothenburg. "More research is needed to understand underlying mechanisms and to evaluate the potential benefits of hormone replacement."

"We cannot say that DHEA-S is protective because we have only studied an association," she added. "A potential practical implication is that established cardiovascular risk factors perhaps should be assessed and treated more aggressively in men with lower DHEA-S levels. However, this must be evaluated in future studies; today, DHEA-S level is not part of cardiovascular-risk assessment."

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Vitamin B6 deficiency associated with inflammation

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In a study described online on May 23, 2012 in the Journal of Nutrition, researchers at Tufts University in Boston report a relationship between low levels of plasma pyridoxal-5'-phosphate (PLP), which indicate reduced levels of vitamin B6, with an increase in markers of inflammation.

"Low vitamin B6 status, based on plasma concentrations of pyridoxal-5-phosphate, has been identified in inflammatory diseases, including cardiovascular disease, rheumatoid arthritis, inflammatory bowel disease, and diabetes," write Lydia Sakakeeny of Tufts Jean Mayer USDA Human Nutrition Research Center and her colleagues. "Our objective was to examine the association between plasma PLP and multiple markers of inflammation in a community based cohort."

The current study included 2229 men and women enrolled in the Framingham Offspring study, who were recruited in 1971 and have undergone periodic examinations thereafter. Blood drawn between 1998 and 2001 was analyzed for plasma PLP and 13 markers of inflammation, including C-reactive protein, fibrinogen, interluekin-6, tumor necrosis factor-alpha and other factors.

The researchers created inflammation scores based on the values of each inflammatory marker. An inverse relationship was observed between high inflammation scores and low levels of PLP. The authors note that decreased plasma PLP levels may reflect mobilization of PLP into inflammatory sites and that a causative relationship between reduced vitamin B6 levels and inflammation cannot be determined. However, they conclude that "This study in combination with past findings further supports our hypothesis that inflammation is associated with a functional deficiency of vitamin B6."

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