Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Hypogonadism in Males with Rheumatoid Arthritis.

McMurray,  Dannette S. Johnson and Robert W.

Background:

The pituitary-gonadal axis has significant immunoregulatory effects on autoimmune diseases and a role in the pathogenesis or modulation of rheumatoid arthritis (RA) has been suggested. We investigated the role of sex hormones on disease activity of male RA patients.

Methods:

Levels of testosterone (T) and prolactin (PRL) were examined in male patients with a diagnosis of RA (n=67) from a Jackson subpopulation of the Veterans Affairs Rheumatoid Arthritis (VARA) registry. Serum T and PRL were determined by RIA in a blinded fashion and the correlation with disease activity and severity calculated.

Results:

Patients had the following demographics (age=68.3 yrs (range 40–91 yrs), disease duration =14.5 yrs (range 1.7–32.5 yrs), RF positive =79%, CCP positive = 70%, mean DAS 28 = 3.2 ± 1.4). Although mean PRL levels were within normal limits with 5 patients being hypoprolactinemic and 3 with high PRL, hypogonadal patients had significantly higher prolactin levels (mean=8.02 ng/ml vs. 5.55 ng/ml, p=0.39) than patients with normal T. Mean T levels were 302 ± 121 ng/dl and there was no relationship to age or DAS28. A surprisingly high number (n=24; 36%) of male RA patients in this study were hypogonadal (T < 250 ng/dl) which was associated with higher BMI (p=0.001). There was no statistical relationship between low serum total testosterone and age, disease activity and severity, and corticosteroid or narcotic use. However, patients with hypogonadism had a trend toward higher CRP (mg/l) (mean= 14.96) that was >40% higher than those patients with normal T levels (CRP 8.95; p=0.08).

Table. Characteristics of male patients with RA.

 Low Testosterone (T < 250 ng/dl)Normal Testosterone (T >= 250 ng/dl)P-value
Testosterone (ng/dl)183.5 ± 50368.7 ± 94 
Prolactin (ng/ml)8.02 ± 85.55 ± 20.039
Age69.8 ± 1067.5 ± 90.17
BMI30.4 ± 626.1 ± 50.003
RF (+)79%79%0.76
ACCP (+)71%70%0.85
CRP (mg/l)14.96 ± 248.95 ± 110.08
DAS283.3 ± 1.33.1 ± 1.40.28
Erosion on hand X-ray58.3%56.7%0.95
Nodules58.3%44.2%0.39

Conclusion:

There was a high prevalence of hypogonadism in our male RA population. Hypogonadal men had higher prolactin levels and BMI and a trend toward higher CRP levels. These findings suggest hypogonadal men may fare worse overall and consideration should be given to screening testosterone in older men with RA.

To cite this abstract, please use the following information:
McMurray, Dannette S. Johnson and Robert W.; Hypogonadism in Males with Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1040
DOI: 10.1002/art.28807

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