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Background <p>Dehydroepiandrosterone sulfate (DHEAS), an abundant adrenal androgen with potential metabolic effects, has been linked to obesity risk in previous studies. However, findings have been inconsistent and large-scale epidemiological data remain limited. This study aimed to examine the association between serum DHEAS levels and body weight status in a nationally representative sample of U.S. adults.</p> Methods <p>We conducted a cross-sectional analysis using data from the 2021–2023 cycle of the National Health and Nutrition Examination Survey (NHANES). After excluding individuals with missing or unreliable data on key variables, a total of 4374 adults aged ≥ 20 years were included. Serum DHEAS was measured via isotope dilution liquid chromatography-tandem mass spectrometry. Body weight status was classified based on BMI categories. Survey-weighted linear, binary logistic, and ordinal logistic regression models were used to assess associations between DHEAS levels and BMI as well as the odds of being in a higher BMI category, adjusting for demographic, socioeconomic, and hormonal covariates. Stratified analyses were performed by sex and age group.</p> Results <p>Higher serum DHEAS levels were significantly associated with lower BMI (<i>β</i> = -0.52; 95% CI: -0.84, -0.20; <i>p</i> = 0.014) after full adjustment. Logistic regression showed that elevated DHEAS was independently associated with a reduced risk of BMI-defined obesity (OR = 0.86; 95% CI: 0.76, 0.98; <i>p</i> = 0.035), but not overweight. Consistently, ordinal logistic regression demonstrated that higher DHEAS levels were associated with reduced odds of belonging to a higher BMI category. Stratified analyses revealed that the inverse association with obesity was stronger in women and older adults, particularly older women (OR = 0.64; 95% CI: 0.51, 0.81; <i>p</i> = 0.004).</p> Conclusion <p>In this cross-sectional analysis of U.S. adults, higher serum DHEAS levels were independently associated with lower BMI and lower likelihood of more advanced BMI categories, with notable sex- and age-specific differences. These findings suggest that DHEAS may represent a promising therapeutic target, particularly for older women, in the prevention and management of obesity-related metabolic disorders.</p>

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Association between serum dehydroepiandrosterone sulfate levels and body weight status among US adults: findings from NHANES 2021–2023

  • 期刊论文

  • 发表日期：

    2026年1月30日

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  • Lianhui Chen,
  • Jiani Zhang,
  • Min Wu,
  • Zhenzhong Zeng,
  • Xiaohao Hu,
  • Yongfen Wang

摘要

Background

Dehydroepiandrosterone sulfate (DHEAS), an abundant adrenal androgen with potential metabolic effects, has been linked to obesity risk in previous studies. However, findings have been inconsistent and large-scale epidemiological data remain limited. This study aimed to examine the association between serum DHEAS levels and body weight status in a nationally representative sample of U.S. adults.

Methods

We conducted a cross-sectional analysis using data from the 2021–2023 cycle of the National Health and Nutrition Examination Survey (NHANES). After excluding individuals with missing or unreliable data on key variables, a total of 4374 adults aged ≥ 20 years were included. Serum DHEAS was measured via isotope dilution liquid chromatography-tandem mass spectrometry. Body weight status was classified based on BMI categories. Survey-weighted linear, binary logistic, and ordinal logistic regression models were used to assess associations between DHEAS levels and BMI as well as the odds of being in a higher BMI category, adjusting for demographic, socioeconomic, and hormonal covariates. Stratified analyses were performed by sex and age group.

Results

Higher serum DHEAS levels were significantly associated with lower BMI (β = -0.52; 95% CI: -0.84, -0.20; p = 0.014) after full adjustment. Logistic regression showed that elevated DHEAS was independently associated with a reduced risk of BMI-defined obesity (OR = 0.86; 95% CI: 0.76, 0.98; p = 0.035), but not overweight. Consistently, ordinal logistic regression demonstrated that higher DHEAS levels were associated with reduced odds of belonging to a higher BMI category. Stratified analyses revealed that the inverse association with obesity was stronger in women and older adults, particularly older women (OR = 0.64; 95% CI: 0.51, 0.81; p = 0.004).

Conclusion

In this cross-sectional analysis of U.S. adults, higher serum DHEAS levels were independently associated with lower BMI and lower likelihood of more advanced BMI categories, with notable sex- and age-specific differences. These findings suggest that DHEAS may represent a promising therapeutic target, particularly for older women, in the prevention and management of obesity-related metabolic disorders.