[Hypogonadism in men with inflammatory joint diseases: Frequency and clinical characteristics]
T S Panevin1,2, R V Rozhivanov3, E G Zotkin1
1Nasonova Research Institute of Rheumatology.
Insights
Hypogonadism (HG) affects 17-32% of men with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. While not linked to disease stage, HG correlates with increased inflammation and metabolic issues in these rheumatic conditions.
Area of Science:
- Rheumatology and Endocrinology
- Men's Health
- Metabolic Disorders
Background:
- Rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) are chronic inflammatory conditions.
- Hypogonadism (HG), characterized by low testosterone (TS) levels, is a potential comorbidity in men with rheumatic diseases (RDs).
Purpose of the Study:
- To determine the frequency of HG in men diagnosed with RA, AS, and PsA.
- To investigate the impact of HG on the clinical presentation and course of these rheumatic diseases and associated comorbidities.
Main Methods:
- A study involving 170 men with RA, 57 with AS, and 85 with PsA.
- Assessment of total testosterone (TS) levels to identify HG, followed by comparative analysis of clinical, demographic, and laboratory markers between patients with and without HG.
Main Results:
- The incidence of TS deficiency (HG) was 24.1% in RA, 17.5% in AS, and 31.8% in PsA.
- HG in RA was associated with higher BMI, glucose, uric acid, ESR, and anemia. In AS, HG correlated with lower hemoglobin, anemia, higher CRP, and ESR. In PsA, HG was linked to older age, higher BMI, glucose, and obesity.
- Despite these associations, HG was not linked to the stage or activity of the RD, and hormone levels and disease markers were similar across HG patient groups regardless of the specific RD.
Conclusions:
- Low testosterone levels and HG are common in men with RA, AS, and PsA.
- HG is associated with increased inflammatory markers, anemia, and metabolic disturbances but not disease stage or activity.
- HG patients, irrespective of their specific rheumatic disease, exhibit similar sex hormone profiles and disease-related indicators.
Aim:
To study the frequency of hypogonadism (HG) in men with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to evaluate the impact of HG on the course of RA and and concomitant diseases.
Materials And Methods:
A single-stage continuous study included 170 men with RA, 57 men with AS and 85 men with PsA, who were hospitalized at the Nasonova Research Institute of Rheumatology. Patients were assessed for total testosterone (ТS) levels and subsequently divided into subgroups with normal (>12 nmol/l) and reduced levels. An intergroup comparison was carried out on the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of rheumatic disease, as well as on concomitant conditions. The second stage of the study involved a pairwise intergroup comparison among patients with HG with RA, AS and PsA.
Results:
The incidence of ТS deficiency among patients with RA was 24.1%, among patients with AS - 17.5%, and with PsA - 31.8%. In patients with RA, HG was associated with a significantly higher mean body mass index, higher fasting blood glucose and uric acid, higher erythrocyte sedimentation rate and anemia. Patients with AS with HG had significantly lower hemoglobin levels and more frequent anemia, as well as higher levels of C-reactive protein and erythrocyte sedimentation rate. In PsA, older age was observed in the androgen deficiency group, as well as higher body mass index and fasting glucose levels; obesity was more common. An intergroup comparison of quantitative and qualitative indicators between patients with androgen deficiency in all three rheumatic diseases (RDs) did not reveal significant differences in the average concentrations of ТS, luteinizing hormone, sex hormone binding globulin, experience of RD, laboratory markers of inflammatory activity, as well as glucose and uric acid. A similar incidence of diabetes mellitus, obesity and anemia was noted for all three nosologies.
Conclusion:
ТS levels and the presence of HG were not associated with the stage and activity of RD, but ТS deficiency was accompanied by higher laboratory indicators of inflammatory activity, lower hemoglobin values, and metabolic disorders. Patients with HG, regardless of nosology, had similar levels of sex hormones and indicators reflecting RD and concomitant conditions.
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