Tuesday, November 15, 2016

An article that appeared in the January 2017 issue of the journal Diabetologia reports an association between higher serum levels of the hormone dehydroepiandrosterone (DHEA) and a lower risk of type 2 diabetes.

The investigation involved participants in the Rotterdam Study, which enrolled 7,983 men and women aged 55 and older from 1990–1993 (Rotterdam Study I) and 3,011 participants in 2000 (Rotterdam study II). Follow–up visits were conducted every three to five years. Serum levels of DHEA, its derivatives DHEA–sulfate and androstenedione, and other factors were measured during Rotterdam Study I subjects' third visit and at enrollment in Rotterdam Study II.

The current study was limited to 5,189 subjects who were free of diabetes at enrollment. Over a median follow–up of 10.9 years, 643 cases of type 2 diabetes were diagnosed.

As DHEA levels increased, the risk of diabetes declined. Among those whose serum DHEA levels were among the top one–third of participants, there was an adjusted 27% lower risk of diabetes in comparison with those whose levels were among the lowest third.

As possible protective mechanisms for DHEA, the authors note that the hormone is a peroxisome proliferator–activated receptor (PPAR) alpha agonist, as are fibrate drugs currently used to treat high triglyceride levels. The fibrate drug bezafibrate was found in one study to reduce the incidence and delay the onset of type 2 diabetes in subjects with impaired fasting glucose. DHEA has also been shown to be an insulin sensitizer and to help protect against advanced glycation end–product formation. Additionally, DHEA is associated with better endothelial function which, when impaired, has been associated with insulin resistance.

"We conclude that higher serum levels of DHEA are independently associated with a decreased risk of developing type 2 diabetes in healthy populations of both men and postmenopausal women," authors Adela Brahimaj and colleagues at Erasmus University Medical Center in the Netherlands conclude. "These prospective data suggest that DHEA may play a role in the pathogenesis of type 2 diabetes, which may have important implications for preventive interventions."