Circulating dehydroepiandrosterone sulfate level and cardiovascular or all-cause mortality in the elderly population: a meta-analysis

Studies have yielded contradictory results concerning the association between dehydroepiandrosterone sulfate (DHEAS) and mortality in the elderly population. This meta-analysis aimed to evaluate the association of low serum DHEAS level with cardiovascular or all-cause mortality in the elderly population. A comprehensive literature search was conducted in PubMed and Embase databases up to 4 February, 2019. Longitudinal observational studies reporting multivariate adjusted risk ratio (RR) and corresponding 95% confidence intervals (CI) for cardiovascular or all-cause mortality with respect to baseline low DHEAS level were included. Both fixed-effect and random effect model were used to pool the overall risk estimate. Methodological quality of the included studies was evaluated using a 9-point Newcastle-Ottawa Scale. Six prospective studies enrolling 6,744 individuals were identified. Five studies were graded as high methodological quality. When compared the lowest to the reference higher circulating DHEAS level, the pooled RR of all-cause and cardiovascular mortality was 1.46 (95% CI: 1.25-1.70) and 1.49 (95% CI: 1.11-1.99), respectively. Subgroup analysis indicated that the association of low DHEAS level with all-cause mortality risk was only found in men (RR 1.41;95% CI: 1.18-1.69) but not in women (RR 1.72; 95% CI: 0.99-2.99). This meta-analysis provides evidence that low circulating DHEAS level is associated with increased risk all-cause mortality in the elderly population.