Association Between Urinary Albumin Excretion and Serum Dehydroepiandrosterone Sulfate Concentration in Male Patients With Type 2 Diabetes

Abstract

OBJECTIVE—Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with type 2 diabetes. Both elevated urinary albumin excretion and low serum concentrations of dehydroepiandrosterone (DHEA) are associated with increased CVD mortality. This raises the possibility of DHEA as a causal intermediate linking urinary albumin excretion to CVD.

RESEARCH DESIGN AND METHODS—Relationships of urinary albumin excretion to serum DHEA sulfate (DHEA-S) concentration and to major cardiovascular risk factors, including blood pressure, serum lipid concentration, glycemic control (HbA_1c), and BMI, were investigated in 357 consecutive men with type 2 diabetes.

RESULTS—Serum DHEA-S concentrations were lower in patients with macroalbuminuria (866.5 ± 523.8 ng/ml, P < 0.0001) and in those with microalbuminuria (1,014.4 ± 525.3 ng/ml, P = 0.0006) than in patients with normoalbuminuria (1,232.6 ± 542.4 ng/ml). Serum DHEA-S concentration correlated inversely with log (urinary albumin excretion) (r = −0.227, P < 0.0001). Multiple regression analysis demonstrated that duration of diabetes (β = 0.147, P = 0.0075), HbA_1c (β = 0.156, P = 0.0048), BMI (β = 0.194, P = 0.0007), systolic blood pressure (β = 0.195, P = 0.0005), and serum DHEA-S concentration (β = −0.192, P = 0.0010) were independent determinants of log (urinary albumin excretion).

CONCLUSIONS—Serum DHEA-S concentration, which correlated inversely with degree of urinary albumin excretion, may contribute to the link between elevated urinary albumin excretion and higher CVD mortality in male patients with type 2 diabetes.