Table 5.
Rate ratio of myocardial infarction by quartile of DHEA-S concentration and subset of age, estrogen status, and fasting status among predominantly postmenopausal women in the Nurses’ Health Study.
| Hormone concentration quartile categories |
P value for linear trend |
P value for interaction |
||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | |||
| DHEA-S, nmol/L | <709 | 710–1110 | 1111–1674 | ≥1675 | ||
| Age <60, n cases/n controls | 9/24 | 20/37 | 26/57 | 35/62 | 0.89 | |
| Adjusted RR (95% CI) | 1.0 (referent) | 1.70 (0.88–3.29) | 1.70 (0.92–3.17) | 1.81 (1.01–3.24) | 0.14 | |
| Age ≥60, n cases/n controls | 34/88 | 41/74 | 35/51 | 22/45 | ||
| Adjusted RR (95% CI) | 1.0 (referent) | 1.33 (0.93–1.89) | 1.51 (1.01–2.26) | 1.40 (0.89–2.18) | 0.38 | |
| Estrogen negative, n cases/n controlsa | 28/69 | 33/49 | 37/57 | 32/46 | 0.79 | |
| Adjusted RR (95% CI) | 1.0 (referent) | 1.48 (0.98–2.22) | 1.52 (1.02–2.27) | 1.76 (1.13–2.75) | 0.10 | |
| Estrogen positive, n cases/n controlsb | 15/43 | 28/62 | 24/51 | 25/61 | ||
| Adjusted RR (95% CI) | 1.0 (referent) | 1.29 (0.80–2.06) | 1.58 (0.95–2.61) | 1.38 (0.84–2.25) | 0.26 | |
| Fasting (≥10 h), n cases/n controls | 24/71 | 44/73 | 36/62 | 32/60 | 0.18 | |
| Adjusted RR (95% CI) | 1.0 (referent) | 1.77 (1.19–2.62) | 2.14 (1.34–3.40) | 1.97 (1.25–3.11) | 0.08 | |
| Nonfasting (<10 h or unknown), n cases/n controls | 19/41 | 17/38 | 25/46 | 25/47 | ||
| Adjusted RR (95% CI) | 1.0 (referent) | 1.00 (0.58–1.70) | 1.05 (0.64–1.72) | 1.17 (0.71–1.94) | 0.32 | |
Conditional logistic regression additionally controlling for age at blood draw (as a linear continuous variable), time of blood collection (1201–0700, 0701–1100, 1101–1200), fasting status at blood collection (fasting for ≥10 h vs <10 h or unknown), menopausal status (postmenopausal, uncertain status vs premenopausal), parents’ history of myocardial infarction, current postmenopausal hormone use, history of diabetes, history of hypertension, history of hypercholesterolemia, aspirin use, mean alcohol intake, body mass index, physical activity in MET-hours (the latter 3 variables modeled as continuous variables with natural cubic splines).
Postmenopausal and not on estrogen therapy at time of blood sampling.
Premenopausal or on estrogen therapy at time of blood sampling.