Association of endogenous DHEA/DHEAS with coronary heart disease: A systematic review and meta-analysis

The clinical significance of dehydroepiandrosterone (DHEA) and its sulphate (DHEAS) in coronary heart disease (CHD) has not been thoroughly elucidated to date. We performed a meta-analysis to clarify the correlations between endogenous DHEA(S) and CHD. We performed a literature search without language restriction up to August 10, 2017, and retrieved records from EMBase, PubMed, Web of Science, CNKI and WanFang databases to identify eligible cohort studies focused on the relation between DHEA(S) and CHD. A total of 26 studies were included in the systematic review and 14 case-control studies were included in the meta-analysis,which was performed using RevMan 5.1 and STATA 12. Subgroup analyses were used to discover possible sources of heterogeneity. Quality assessment was carried out using the Newcastle-Ottawa Scale. Odds ratios with 95% confidence intervals were calculated. Heterogeneity analyses were performed using meta-regression and tests for publication bias were performed. The overall average DHEAS diffusivity of CHD cases was significantly lower than that of controls with a summarized standard (std) mean difference of -0.23(95% CI, -0.45 to -0.01, P = .04). There was no association between DHEA concentration and CHD with a summarized mean difference of -0.07 (95% CI, -0.32 to 0.18, P = .59). No association was found between DHEAS concentration and arteriosclerosis patients with a summarized standard (std) mean difference of -0.46(95% CI, -0.96 to 0.04, P = .07). All of the results had a high degree of heterogeneity. The present study suggested that decreased DHEAS may be associated with coronary heart disease risk but not with arteriosclerosis. We did not find a significant association between DHEA and CHD risk.