Cortisol, DHEA, sulphate, their ratio, and all-cause and cause-specific mortality in the Vietnam experience study

Phillips, Anna C., Carroll, Douglas, Gale, Catherine R., Lord, Janet M., Arlt, Wiebke and Batty, G. David (2010) Cortisol, DHEA, sulphate, their ratio, and all-cause and cause-specific mortality in the Vietnam experience study. European journal of endocrinology, 163 (2), 285-292. (doi:10.1530/EJE-10-0299). (PMID:20498139)

Abstract

Objectives: The aim of the present analyses was to examine the association between cortisol, DHEA sulphate (DHEAS) and the cortisol:DHEAS ratio and mortality.

Design: This was a prospective cohort analysis.

Methods: Participants were 4255 Vietnam-era US army veterans. From military service files, telephone interviews and a medical examination, occupational, socio-demographic and health data were collected. Contemporary morning fasted cortisol and DHEAS concentrations were determined. Mortality was tracked over the subsequent 15 years. The outcomes were all-cause, cardiovascular disease, cancer, other medical mortality and external causes of death. Cox proportional hazard models were tested, initially with adjustment for age, and then with adjustment for a range of candidate confounders.

Results: In general, cortisol concentrations did not show an association with all-cause or cause-specific mortality. However, in age-adjusted and fully adjusted analyses, DHEAS was negatively related to all-cause, all cancers and other medical mortality; high DHEAS concentrations were protective. The cortisol:DHEAS ratio was also associated with these outcomes in both age-adjusted and fully adjusted models; the higher the ratio, the greater the risk of death.

Conclusions: DHEAS was negatively associated, and the ratio of cortisol to DHEAS was positively associated with all-cause, cancer and other medical cause mortality. Further experimental study is needed to elucidate the mechanisms involved in these relationships.

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Contributors

Author: Catherine R. Gale

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