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A study of serum androgen and cortisol levels in female patients with rheumatoid arthritis. Correlation with disease activity

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Summary

Androgen status and the role played by androgens in the pathogenesis of rheumatoid arthritis (RA) in female patients are a matter of debate. In the present study serum testosterone (T), DHEAS, sex hormone binding globulin (SHBG) and cortisol levels were determined in 55 RA women, both in pre- and post-menopausal (M) status, and in a group of healthy subjects. Patients were divided into two groups according to disease activity and a correlation analysis of hormonal levels against serum IL1β levels was performed. No significant differences were found in serum T levels between RA patients and controls, both in preM (1.38±0.4 vs 1.35±0.3 nmol/l; p=ns) and in postM status (1.21±0.2 vs 1.10±0.2 nmol/l; p=ns). Serum SHBG levels were lower in RA patients than in control subjects, both in pre and in postM status. DHEAS levels were significantly lower in preM RA patients than in controls (2.34±1.2 vs 5.93±1.6 µmol/l; p<0.001) while cortisol levels were significantly higher in preM active RA patients than in controls (466.2±30.3 vs 411±66.2 nmol/l; p=0.02). IL1β levels were significantly higher in RA patients than in controls both in pre- and postM subjects (70±33.8 vs 23.1±2.9 and 92±27.4 vs 31.9±3.1 fmol/l, p<0.001, respectively).

Although androgen status could play a role in the pathogenesis of RA, at present it is not possible to exclude the influence of RA itself on sex hormone profile.

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References

  1. Masi, A.T., Josipovic, D.B., Jefferson, W.E. Low adrenal androgenic-anabolic steroids in women with rheumatoid arthritis: gas liquid chromatographic studies of RA patients and matched normal control women indicating decreased 11-deoxy-ketosteroid excretion. Semin Arthritis Rheum 1984, 14, 1–23.

    Article  PubMed  Google Scholar 

  2. Semple, C.G., Gray, C.E., Beastall, G.H. Adrenal androgen and illness. Acta Endocrinol. (Copenh) 1987, 116, 155–160.

    PubMed  Google Scholar 

  3. Zumoff, B., Bradlow, H.L., Gallagher, T.F., Hellman, L. Decreased conversion of androgens to normal 17-ketosteroid metabolites: a nonspecific consequence of illness. J Clin Endocrinol Metab 1971, 32, 824–832.

    PubMed  Google Scholar 

  4. Parker, L.N., Levin, E.R., Lifrak, E.T. Evidence for adrenocortical adaptation to severe illness. J Clin Endocrinol Metab 1985, 60, 947–952.

    PubMed  Google Scholar 

  5. Gordon, D., Beastall, G.H., Thompson, J.A., Sturroch, R.D. Androgenic status and sexual function in males with rheumatoid arthritis and ankylosing spondylitis. Br J Rheumatol 1986, 60, 671–679.

    Google Scholar 

  6. Spector, T.D., Perry, L.A., Tubb, G., Silman, A.J., Huskisson, E.C. Low free testosterone levels in rheumatoid arthritis. Ann Rheum Dis 1988, 47, 65–68.

    PubMed  Google Scholar 

  7. Spector, T.D., Ollier, W., Perry, L.A., Silman, A.J., Thompson, P.W., Eduards, A. Free and serum testosterone levels in 276 males: a comparative study of rheumatoid arthritis, ankylosing spondylitis and healthy controls. Clin Rheum 1989, 8, 37–41.

    Article  Google Scholar 

  8. Cutolo, M., Balleari, E., Giusti, M., Monachesi, M., Accardo, S. Sex hormone status of male patients with rheumatoid arthritis: evidence of low serum concentration of testosterone at baseline and after human chorionic gonadotropin stimulation. Arthritis Rheum 1988, 31, 1314–1317.

    PubMed  Google Scholar 

  9. Gordon, D., Beastall, G.H., Thompson, J.A., Sturroch, R.D. Prolonged hypogonadism in male patients with rheumatoid arthritis during flares in disease activity. Br J Rheumatol 1988, 27, 440–444.

    PubMed  Google Scholar 

  10. Feher, K.G., Feher, T., Merety, K. Interrelationship between the immunological and steroid hormone parameters in rheumatoid arthritis. Exp Clin Endocrinol 1986, 87, 38–42.

    PubMed  Google Scholar 

  11. Sambrook, P.N., Eisman, J.A., Champion, G.D., Pocock, N.A. Sex hormone status and osteoporosis in postmenopausal women with rheumatoid arthritis. Arthritis Rheum 1988, 31, 973–978.

    PubMed  Google Scholar 

  12. Sambrook, P.N., Birmingham, J., Champion, G.D., Kelly, P., Kempler, S., Freund, J., Eisman, J.A. Postmenopausal bone loss in rheumatoid arthritis: effect of estrogens and androgens. J Rheumatol 1992, 19, 357–361.

    PubMed  Google Scholar 

  13. Hedman, M., Nilsson, E., De la Torre, B. Low blood and synovial fluid levels of sulpho-conjugated steroids in rheumatoid arthritis. Clin Exp Rheumatol 1992, 10, 25–30.

    PubMed  Google Scholar 

  14. Cutolo, M., Balleari, E., Giusti, M., Monachesi, M., Accardo, S. Sex hormone status in women suffering from rheumatoid arthritis. J Rheumatol 1986, 13, 1019–1023.

    PubMed  Google Scholar 

  15. Benito-Urbina, S., Arnalich Fernandez, F., Gonzales Gancedo, P., De Miguel Mendita, E., Gijon Banos, J. The hormonal changes in postmenopausal women with rheumatoid arthritis. Rev Clin Espanola 1992, 190, 181–183.

    Google Scholar 

  16. Dougados, M., Nahoul, K., Benhamu, L., Amor, B. Androgen plasmal levels in female rheumatoid arthritis patients (Letter). Arthritis Rheum 1983, 26, 935–936.

    PubMed  Google Scholar 

  17. Spector, T.D., Perry, L.A., Tubb, G., Huskisson, E.C. Androgen status of females with RA (Letter). Br J Rheumatol 1987, 25, 316–317.

    Google Scholar 

  18. Hall, G.M., Perry, L.A., Spector, T.D. Depressed levels of dehydroepiandrosterone sulphate in postmenopausal women with rheumatoid arthritis but no relation with axial bone density. Ann Rheum Dis 1993, 52 211–214.

    PubMed  Google Scholar 

  19. Nestler, J.E, Clore JN, Blackard WG. Metabolism and actions of dehydroepiandrosterone in humans. J Steroid Biochem Mol Biol 1991, 40, 599–605.

    Article  PubMed  Google Scholar 

  20. Van Den Brink, H.R., Blankenstein, M.A., Koppeschaar, H.P.F., Bijlsma, J.W.J. Influence of disease activity on steroid hormone levels in peripheral blood of patients with rheumatoid arthritis. Clin Exp Rheumatol 1993, 11, 649–652.

    PubMed  Google Scholar 

  21. Arnett, F.C., Edworthy, S.M., Bloch, D.A., McShane, D.J., Fries, J.F., Cooper, N.S., Healey, L.A., Kaplan, S.R., Liang, M.H., Luthra, H.S., Medsger, T.A. Jr., Mitchell, D.M., Neustadt, D.H., Pinals, R.S., Schaller, J.G., Sharp, J.T., Wilder, R.L., Hunder, G.G. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988, 31, 315–324.

    PubMed  Google Scholar 

  22. Cobb, S., Merchant, W.R., Thompson, D.J. An estimate of the prevalence of rheumatoid arthritis. J Chron Dis 1957, 5, 636–643.

    Article  PubMed  Google Scholar 

  23. Masi, A.T. Population studies in rheumatic disease. Rev Med 1967, 18, 185–206.

    Article  Google Scholar 

  24. Ahmed, S.A., Talal, N. Sex hormones and autoimmune rheumatic diseases. Scand J Rheumatol 1989, 16, 69–76.

    Google Scholar 

  25. Persellin, R.H. The effect of pregnancy on rheumatoid arthritis. Bull Rheum Dis 1977, 27, 922–927.

    Google Scholar 

  26. Latman, N.S. Relation of menstrual cycle phase to symptoms of rheumatoid arthritis. Am J Med 1983, 74, 957–960.

    Article  PubMed  Google Scholar 

  27. How, J., Zheng, W.F. Effect of sex hormones on NK and ADCC activity of mice. Int J Immunopharmacol 1988, 10, 15–19.

    PubMed  Google Scholar 

  28. Holdstok, G., Chastenay, B.F., Krawitt, E.L. Effect of testosterone, oestradiol and progesterone on immune regulation. Clin Exp Immunol 1982, 47, 449–456.

    PubMed  Google Scholar 

  29. Schuurs, A.H.W.M., Verheul, H.A.M. Sex hormones and autoimmune disease. Br J Rheumatol 1989, 28 (Suppl 1), 59–61.

    PubMed  Google Scholar 

  30. Grossman, C.J., Sholiton, L.J., Helmsworth, J.A. Characteristics of cytoplasmic and nuclear dihydrotestosterone receptor of human thymic tissue. Steroids 1983, 42, 11–22.

    Article  PubMed  Google Scholar 

  31. McCruden, A.B., Stimson, W.H. Androgen receptors in the human thymus. Immunol 1984, 8, 49–53.

    Google Scholar 

  32. Kovacs, W.J., Olsen, N.J. Androgen receptors in human thymocytes. J Immunol 1987, 139, 490–493.

    PubMed  Google Scholar 

  33. Cutolo, M., Accardo, S., Villaggio, B., Indiveri, F., Clerico, P., Carruba, G., Fecarotta, E., Castagnetta, L. Evidence for the presence of androgen receptors in the synovial tissue of rheumatoid arthritis patients and healthy controls. Arthritis Rheum 1992, 35, 1007–1015.

    PubMed  Google Scholar 

  34. Araneo, B.A., Dowell, T., Diegel, M., Daynes, R.A. Dihydrotestosterone exerts influence on the production of interleukin 4 (IL-4), IL-5 and γ-interferon (γ-INF), but not IL-2 by activated murine T cells. Blood 1991, 78, 688–699.

    PubMed  Google Scholar 

  35. Schuurs, A.H.V.M., Verheul, H.A.M. Effects of gender and sex steroids on the immune response. J Steroid Biochem 1990, 35, 157–172.

    Article  PubMed  Google Scholar 

  36. Kasson, B., Gorospe, W. Effects of interleukins 1, 2 and 3 on follicle-stimulating hormone-induced differentiation of rat granulosa cells. Mol Cell Endocrinol 1989, 62, 103–111.

    Article  PubMed  Google Scholar 

  37. Folomeev, M., Dougados, M., Beaune J., Kouyoumdjian, J.C., Nahoul, K., Amor, B., Alekberova, Z. Plasma sex hormones and aromatase activity in tissues of patients with systemic lupus erythematosus. Lupus 1992, 1, 191–195.

    PubMed  Google Scholar 

  38. Altomonte, L., Zoli, A., Mirone, L., Scolieri, P., Magarò, M. Serum levels of interleukin 1β, tumor necrosis factor α and interleukin 2 in rheumatoid arthritis. Correlation with disease activity. Clin Rheumatol 1992, 11, 202–205.

    Article  PubMed  Google Scholar 

  39. Orentreich, N., Brind, L.J., Rizer, L.R., Vogelman, J.H. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab 1984, 59, 551–555.

    PubMed  Google Scholar 

  40. Hurwitz, A., Payne, D.W., Packman, J.N., Andreani, C.L., Resnick, C.E., Hernandez, E.R., Adashi, E.Y. Cytokine-mediated regulation of ovarian function: interleukin-1 inhibits gonadotropin-induced androgen biosynthesis. Endocrinology 1991, 129, 1250–1256.

    PubMed  Google Scholar 

  41. Deighton, C.M., Watson, M.J., Walker, D.J. Sex hormones in postmenopausal HLA-identical rheumatoid arthritis discordant sibling pairs. J Rheumatol 1992, 19, 1663–1667.

    PubMed  Google Scholar 

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Mirone, L., Altomonte, L., D'Agostino, P. et al. A study of serum androgen and cortisol levels in female patients with rheumatoid arthritis. Correlation with disease activity. Clin Rheumatol 15, 15–19 (1996). https://doi.org/10.1007/BF02231678

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