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Lower testosterone levels predicted RF-negative RA in men
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Lower levels of testosterone were predictive of rheumatoid factor-negative in men with rheumatoid arthritis, according to recent study results.
Researchers in Sweden conducted a nested case-control study using information and blood samples from a population-based health survey conducted between 1974 and 1992. The study included 22,444 males, born between 1921 and 1949, and identified incident cases of rheumatoid arthritis (RA) before linking the cohort to local and national RA registers. For each validated RA case, two matched controls were chosen from the survey. After an overnight fast, participants’ blood was drawn and later analyzed for testosterone levels and other reproductive hormones.
Serum was studied from 104 men who developed RA (mean age, 46 years; median time from screening to RA diagnosis, 12.7 years; 73% rheumatoid factor [RF] positive at diagnosis or later) and 174 matched controls who did not develop RA. Lower testosterone levels were associated with subsequent development of RF-negative RA (OR=0.31 per SD; 95% CI, 0.12-0.85) compared with development of RF-positive RA (OR=0.87 per SD; 95% CI, 0.53-1.43) when conditional logistic regression models were adjusted for smoking and BMI. Pre-RF negative RA had significantly increased follicle-stimulating hormone levels (P=.02), but pre-RF positive RA showed decreased levels of the hormone (P=.02).
“Male sex has been found to be an independent predictor of remission in early RA,” the researchers reported. “This has led to the hypothesis that androgen supplementation may be useful in the management of RA.”
Study results suggest “that hormonal changes precede the onset of RA and affect the disease phenotype,” the researchers concluded. “We report a negative association of testosterone and free testosterone levels with the risk of developing RF-negative RA in men. Since this is the first major study of testosterone and related hormones in the preclinical phase of RA, our findings should be verified in other populations.”
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