Associations of Dehydroepiandrosterone Sulfate With Cardiometabolic Risk Factors in Prepubertal Children

J Clin Endocrinol Metab. 2018 Jul 1;103(7):2592-2600. doi: 10.1210/jc.2018-00184.


Context: Premature adrenarche (PA) has been associated with overweight and insulin resistance, but the associations of serum dehydroepiandrosterone sulfate (DHEAS) concentration with other cardiometabolic risk factors are uncertain.

Objective: To examine the associations of serum DHEAS concentration with several cardiometabolic risk factors in children.

Design: Cross-sectional data from the Physical Activity and Nutrition in Children Study.

Participants: Population sample of 207 girls and 225 boys aged 7.6 ± 0.4 years.

Main outcome measures: Cardiometabolic risk factors by serum DHEAS concentration.

Results: DHEAS correlated positively with body mass index standard deviation score, body fat percentage, lean body mass, high-sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT) when adjusted for age and sex. The associations of DHEAS with hs-CRP and ALT disappeared when adjusted also for body fat percentage. When further adjusted for birth weight SD score, DHEAS correlated negatively with low-density lipoprotein (LDL) cholesterol and LDL/high-density lipoprotein (HDL) cholesterol ratio. LDL cholesterol was lower in children with DHEAS ≥40 µg/dL than in those with DHEAS <40 µg/dL, adjusted for age, sex, and body fat percentage (86.5 vs 92.3 mg/dL, P = 0.029). This association strengthened after further adjustment for birth weight SD score (85.3 vs 92.3 mg/dL, P = 0.012).

Conclusion: Higher DHEAS is not associated with an increased cardiometabolic risk in prepubertal children. Instead, it may be protective, evidenced by an association with lower LDL cholesterol and LDL/HDL cholesterol ratio. The increased cardiometabolic risk in PA shown in many studies may be due to low birth weight and childhood overweight associated with PA.

Trial registration: NCT01803776.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine Transaminase / blood
  • Birth Weight
  • Body Composition
  • Body Mass Index
  • C-Reactive Protein
  • Cardiovascular Diseases / etiology*
  • Child
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Dehydroepiandrosterone Sulfate / blood*
  • Female
  • Humans
  • Male
  • Metabolic Diseases / etiology*
  • Puberty, Precocious / etiology*
  • Risk Factors


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dehydroepiandrosterone Sulfate
  • C-Reactive Protein
  • Alanine Transaminase

Associated data