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. 1998 May;57(5):281–285. doi: 10.1136/ard.57.5.281

Serum androgen-anabolic hormones and the risk of rheumatoid arthritis

R Heikkila 1, K Aho 1, M Heliovaara 1, P Knekt 1, A Reunanen 1, A Aromaa 1, A Leino 1, T Palosuo 1
PMCID: PMC1752601  PMID: 9741311

Abstract

OBJECTIVE—It has been hypothesised, mainly on the basis of indirect evidence, that low serum concentrations of androgen-anabolic hormones would play a causal part in the aetiology of rheumatoid arthritis (RA).
METHODS—A case-control study was nested with a Finnish cohort of 19 072 adults who had neither arthritis nor a history of it at the baseline examination during 1973-1977. Pre-illness serum specimens for the assay of testosterone and dehydroepiandrosterone sulphate (DHEAS) were available from 116 cases who had developed RA by late 1989. Three controls per each incident case were individually matched for sex, age, and municipality.
RESULTS—The mean testosterone concentration was 1.4 nmol/l in those 84 women who developed RA and 1.4 nmol/l in their controls; the corresponding figures for DHEAS were 5.2 µmol/l and 5.5 µmol/l, respectively. Mean testosterone concentration in the 32 male cases was 26.1 nmol/l and 26.4 nmol/l in their controls; the corresponding figures for DHEAS were 11.2 µmol/l and 10.1 µmol/l, respectively. Analysis by subgroups (rheumatoid factor positive and negative disease, premenopausal and postmenopausal women) and by hormone distributions showed no differences.
CONCLUSION—The findings are not in line with the contention that low concentrations of testosterone and DHEAS play a part in the aetiology of RA.

 Keywords: rheumatoid arthritis; epidemiology; testosterone; dehydroepiandrosterone sulphate

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Figure 1  .

Figure 1  

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Testosterone and dehydroepiandrosterone sulphate (DHEAS) concentrations in cases and in controls. Each dot represents one case and the mean of the set of matched controls.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aho K., Heliövaara M., Knekt P., Reunanen A., Aromaa A., Leino A., Kurki P., Heikkilä R., Palosuo T. Serum immunoglobulins and the risk of rheumatoid arthritis. Ann Rheum Dis. 1997 Jun;56(6):351–356. doi: 10.1136/ard.56.6.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alexandersen P., Haarbo J., Christiansen C. The relationship of natural androgens to coronary heart disease in males: a review. Atherosclerosis. 1996 Aug 23;125(1):1–13. doi: 10.1016/0021-9150(96)05864-9. [DOI] [PubMed] [Google Scholar]
  3. Arnalich F., Benito-Urbina S., González Gancedo P., de Miquel E., Gijon Banos J. Elévation des androgènes plasmatiques chez les femmes ménopausées atteintes de polyarthrite rhumatoïde. Rev Rhum Mal Osteoartic. 1990 Jul-Sep;57(7-8):509–512. [PubMed] [Google Scholar]
  4. Bernstein L., Ross R. K. Endogenous hormones and breast cancer risk. Epidemiol Rev. 1993;15(1):48–65. doi: 10.1093/oxfordjournals.epirev.a036116. [DOI] [PubMed] [Google Scholar]
  5. Brennan P., Silman A. Role of androgens in the aetiology of rheumatoid arthritis. Ann Rheum Dis. 1996 Jun;55(6):404–404. doi: 10.1136/ard.55.6.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brennan P., Silman A. Why the gender difference in susceptibility to rheumatoid arthritis? Ann Rheum Dis. 1995 Sep;54(9):694–695. doi: 10.1136/ard.54.9.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Couwenbergs C., Knussmann R., Christiansen K. Comparisons of the intra- and inter-individual variability in sex hormone levels of men. Ann Hum Biol. 1986 Jan-Feb;13(1):63–72. doi: 10.1080/03014468600008201. [DOI] [PubMed] [Google Scholar]
  8. Cutolo M., Accardo S., Balleari E., Sulli A., Seriolo B., Giusti M. Androgen status in postmenopausal patients with rheumatoid arthritis. J Rheumatol. 1993 Dec;20(12):2163–2164. [PubMed] [Google Scholar]
  9. Cutolo M., Balleari E., Accardo S., Samanta E., Cimmino M. A., Giusti M., Monachesi M., Lomeo A. Preliminary results of serum androgen level testing in men with rheumatoid arthritis. Arthritis Rheum. 1984 Aug;27(8):958–959. doi: 10.1002/art.1780270821. [DOI] [PubMed] [Google Scholar]
  10. Cutolo M., Balleari E., Giusti M., Monachesi M., Accardo S. Sex hormone status in women suffering from rheumatoid arthritis. J Rheumatol. 1986 Dec;13(6):1019–1023. [PubMed] [Google Scholar]
  11. Cutolo M., Balleari E., Giusti M., Monachesi M., Accardo S. Sex hormone status of male patients with rheumatoid arthritis: evidence of low serum concentrations of testosterone at baseline and after human chorionic gonadotropin stimulation. Arthritis Rheum. 1988 Oct;31(10):1314–1317. doi: 10.1002/art.1780311015. [DOI] [PubMed] [Google Scholar]
  12. Dai W. S., Kuller L. H., LaPorte R. E., Gutai J. P., Falvo-Gerard L., Caggiula A. The epidemiology of plasma testosterone levels in middle-aged men. Am J Epidemiol. 1981 Dec;114(6):804–816. doi: 10.1093/oxfordjournals.aje.a113251. [DOI] [PubMed] [Google Scholar]
  13. Deighton C. M., Watson M. J., Walker D. J. Sex hormones in postmenopausal HLA-identical rheumatoid arthritis discordant sibling pairs. J Rheumatol. 1992 Nov;19(11):1663–1667. [PubMed] [Google Scholar]
  14. Deighton C. M., Watson M., Walker D. J. RA sex ratios, HLA-DR, and testosterone. Ann Rheum Dis. 1993 Mar;52(3):244–244. doi: 10.1136/ard.52.3.244-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Dougados M., Nahoul K., Benhamou L., Amor B. Androgen plasma levels in female rheumatoid arthritis patients. Arthritis Rheum. 1983 Jul;26(7):935–936. doi: 10.1002/art.1780260727. [DOI] [PubMed] [Google Scholar]
  16. Ebeling P., Koivisto V. A. Physiological importance of dehydroepiandrosterone. Lancet. 1994 Jun 11;343(8911):1479–1481. doi: 10.1016/s0140-6736(94)92587-9. [DOI] [PubMed] [Google Scholar]
  17. Fehér K. G., Fehér T., Merétey K. Interrelationship between the immunological and steroid hormone parameters in rheumatoid arthritis. Exp Clin Endocrinol. 1986 Jun;87(1):38–42. doi: 10.1055/s-0029-1210520. [DOI] [PubMed] [Google Scholar]
  18. Gordon D., Beastall G. H., Thomson J. A., Sturrock R. D. Androgenic status and sexual function in males with rheumatoid arthritis and ankylosing spondylitis. Q J Med. 1986 Jul;60(231):671–679. [PubMed] [Google Scholar]
  19. Gordon D., Beastall G. H., Thomson J. A., Sturrock R. D. Prolonged hypogonadism in male patients with rheumatoid arthritis during flares in disease activity. Br J Rheumatol. 1988 Dec;27(6):440–444. doi: 10.1093/rheumatology/27.6.440. [DOI] [PubMed] [Google Scholar]
  20. 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 Mar;52(3):211–214. doi: 10.1136/ard.52.3.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Heliövaara M., Aho K., Reunanen A., Knekt P., Aromaa A. Parity and risk of rheumatoid arthritis in Finnish women. Br J Rheumatol. 1995 Jul;34(7):625–628. doi: 10.1093/rheumatology/34.7.625. [DOI] [PubMed] [Google Scholar]
  22. James W. H. Rheumatoid arthritis, the contraceptive pill, and androgens. Ann Rheum Dis. 1993 Jun;52(6):470–474. doi: 10.1136/ard.52.6.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. James W. H. The hypothesized hormonal control of mammalian sex ratio at birth--a second update. J Theor Biol. 1992 Mar 7;155(1):121–128. doi: 10.1016/s0022-5193(05)80552-1. [DOI] [PubMed] [Google Scholar]
  24. Kaarela K., Alekberova Z., Lehtinen K., Puolakka K., Koskimies S., Nassonova V., Pospelov L. Seronegative rheumatoid arthritis: a clinical study with HLA typing. J Rheumatol. 1990 Sep;17(9):1125–1129. [PubMed] [Google Scholar]
  25. LaCroix A. Z., Yano K., Reed D. M. Dehydroepiandrosterone sulfate, incidence of myocardial infarction, and extent of atherosclerosis in men. Circulation. 1992 Nov;86(5):1529–1535. doi: 10.1161/01.cir.86.5.1529. [DOI] [PubMed] [Google Scholar]
  26. Masi A. T. Incidence of rheumatoid arthritis: do the observed age-sex interaction patterns support a role of androgenic-anabolic steroid deficiency in its pathogenesis? Br J Rheumatol. 1994 Aug;33(8):697–699. doi: 10.1093/rheumatology/33.8.697. [DOI] [PubMed] [Google Scholar]
  27. Masi A. T. Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Clin Exp Rheumatol. 1995 Mar-Apr;13(2):227–240. [PubMed] [Google Scholar]
  28. Meikle A. W., Bishop D. T., Stringham J. D., West D. W. Quantitating genetic and nongenetic factors that determine plasma sex steroid variation in normal male twins. Metabolism. 1986 Dec;35(12):1090–1095. doi: 10.1016/0026-0495(86)90020-x. [DOI] [PubMed] [Google Scholar]
  29. Nomura A. M., Kolonel L. N. Prostate cancer: a current perspective. Epidemiol Rev. 1991;13:200–227. doi: 10.1093/oxfordjournals.epirev.a036069. [DOI] [PubMed] [Google Scholar]
  30. Ollier W., Spector T., Silman A., Perry L., Ord J., Thomson W., Festenstein H. Are certain HLA haplotypes responsible for low testosterone levels in males? Dis Markers. 1989 Jul-Sep;7(3):139–143. [PubMed] [Google Scholar]
  31. Pladevall-Vila M., Delclos G. L., Varas C., Guyer H., Brugués-Tarradellas J., Anglada-Arisa A. Controversy of oral contraceptives and risk of rheumatoid arthritis: meta-analysis of conflicting studies and review of conflicting meta-analyses with special emphasis on analysis of heterogeneity. Am J Epidemiol. 1996 Jul 1;144(1):1–14. doi: 10.1093/oxfordjournals.aje.a008846. [DOI] [PubMed] [Google Scholar]
  32. Rotter J. I., Wong F. L., Lifrak E. T., Parker L. N. A genetic component to the variation of dehydroepiandrosterone sulfate. Metabolism. 1985 Aug;34(8):731–736. doi: 10.1016/0026-0495(85)90023-x. [DOI] [PubMed] [Google Scholar]
  33. 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 Aug;31(8):973–978. doi: 10.1002/art.1780310805. [DOI] [PubMed] [Google Scholar]
  34. Spector T. D., Ollier W., Perry L. A., Silman A. J., Thompson P. W., Edwards A. Free and serum testosterone levels in 276 males: a comparative study of rheumatoid arthritis, ankylosing spondylitis and healthy controls. Clin Rheumatol. 1989 Mar;8(1):37–41. doi: 10.1007/BF02031066. [DOI] [PubMed] [Google Scholar]
  35. Spector T. D., Perry L. A., Tubb G., Huskisson E. C. Androgen status of females with RA. Br J Rheumatol. 1987 Aug;26(4):316–318. doi: 10.1093/rheumatology/26.4.316. [DOI] [PubMed] [Google Scholar]
  36. 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 Jan;47(1):65–68. doi: 10.1136/ard.47.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]

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