Abstract Background Dehydroepiandrosterone sulfate (DHEA-S) has anti-inflammatory and immune-modulating properties but its role in asthma is unclear. Objective To examine serum DHEA-S levels and asthma or asthma exacerbations in a nationwide study of U.S. adults. Methods Cross-sectional study of serum DHEA-S and asthma in 4,212 adults (2,334 females and 1,878 males) aged 18-79 years who participated in the 2021-2023 U.S. National Health and Nutrition Examination Survey. Eosinophilic and non-eosinophilic asthma were defined by absolute blood eosinophil counts ≥ 300 and 300 cells/uL, respectively. An asthma exacerbation was defined as an asthma attack or an emergency room or urgent care visit due to asthma in the previous year. Logistic regression was used for the multivariable analysis of DHEA-S and asthma or asthma exacerbations, which was conducted separately in females and males. Results Serum DHEA-S levels decreased with age in male and female participants. In an analysis adjusting for other sex hormones and other covariates, serum DHEA-S levels in the fourth quartile were associated with lower odds of asthma in females (odds ratio OR for quartile Q4 vs. Q1 = 0.55, 95% confidence interval CI=0.30-0.98) and in males (OR for Q4 to Q1 = 0.42 95% CI = 0.20-0.87). Similar associations were found for non-eosinophilic asthma but not for eosinophilic asthma. There was a non-significant trend for an association between higher DHEA-S levels and reduced odds of asthma exacerbations in females with asthma (OR for Q4 to Q1 = 0.45 (95% CI = 0.20, 1.01). Conclusions Higher serum DHEA-S levels are associated with lower odds of asthma in a representative sample of U.S. adults.
Han et al. (Mon,) studied this question.