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Sex-specific association of serum dehydroepiandrosterone and its sulfate levels with osteoporosis in type 2 diabetes

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Abstract

Introduction

This study is to investigate the relation between serum dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) levels and the risk of osteoporosis in patients with T2DM.

Materials and Methods

This cross-sectional study involved 938 hospitalized patients with T2DM. Linear regression models were used to explore the relationship between DHEA and DHEAS and the BMD at different skeletal sites. Multinominal logistic regression models and the restricted cubic spline (RCS) were used to evaluate the associations of DHEA and DHEAS with the risks of osteopenia and/or osteoporosis.

Results

In postmenopausal women with T2DM, after adjustment for confounders including testosterone and estradiol, DHEA showed a significant positive correlation with lumbar spine BMD (P = 0.013). Moreover, DHEAS exhibited significant positive correlations with BMD at three skeletal sites: including femoral neck, total hip, and lumbar spine (all P < 0.05). Low DHEA and DHEAS levels were associated with increased risk of osteopenia and/or osteoporosis (all P < 0.05) and the risk of osteoporosis gradually decreased with increasing DHEAS levels (P overall = 0.018, P-nonlinear = 0.559). However, DHEA and DHEAS levels in men over the age of 50 with T2DM were not associated with any of above outcomes.

Conclusion

In patients with T2DM, independent of testosterone and estradiol, higher DHEA and DHEAS levels are associated with higher BMD and lower risk of osteopenia/osteoporosis in postmenopausal women but not men over the age of 50.

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Funding

This work was supported by the National Key R&D Program of China (grant numbers 2019YFA0802502 and 2022YFE0131400); we acknowledge the support of the National Natural Science Foundation of China (grant numbers 81830025 and 82220108014), Tianjin Key Medical Discipline (Specialty) Construction Project (grant number TJYXZDXK-030A), and Major Project of Tianjin Municipal Science and Technology Bureau (grant number 21ZXJBSY00060).

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Author notes

  1. Shuo Li, Wei Li and Lina Chang have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Department of Nephrology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China

    Shuo Li, Wei Li, Lina Chang, Jieying Wan, Shanshan Chen, Xinxin Zhang, Qing He & Ming Liu

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  1. Shuo Li
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  2. Wei Li
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  7. Qing He
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Contributions

SL performed the study, did statistical analysis, and wrote the manuscript. WL and LC did statistical analysis, and wrote the manuscript. JW and SC participated in the study data collection. XZ performed the study, did statistical analysis. QH and ML provided funding support, designed the study, and reviewed the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work ensuring integrity and accuracy.

Corresponding authors

Correspondence to Xinxin Zhang, Qing He or Ming Liu.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional Review Board of Tianjin Medical University General Hospital (approval number: IRB2020-YX-027-01).

Informed consent

Due to the extraction of all patient data from the hospital’s electronic medical records and the anonymization of participants' identities, the study waived the requirement for informed consent.

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Li, S., Li, W., Chang, L. et al. Sex-specific association of serum dehydroepiandrosterone and its sulfate levels with osteoporosis in type 2 diabetes. J Bone Miner Metab 42, 361–371 (2024). https://doi.org/10.1007/s00774-024-01511-9

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  • DOI: https://doi.org/10.1007/s00774-024-01511-9

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