PT - JOURNAL ARTICLE AU - Birgitta Tengstrand AU - Kjell Carlström AU - Ingiäld Hafström TI - Gonadal Hormones in Men with Rheumatoid Arthritis - From Onset Through 2 Years AID - 10.3899/jrheum.080558 DP - 2009 Mar 01 TA - The Journal of Rheumatology PG - jrheum.080558 4099 - http://www.jrheum.org/content/early/2009/02/25/jrheum.080558.short 4100 - http://www.jrheum.org/content/early/2009/02/25/jrheum.080558.full AB - Objective To evaluate changes over a 2-year course in the hypothalamic-pituitary-gonadal (HPG) axis in men with early rheumatoid arthritis (RA) from start of treatment with disease modifying antirheumatic drugs. Methods Forty-one men with early RA and with joint symptoms less than 1 year were studied. Mean age at inclusion was 53 years and mean disease duration 6 months. They were followed prospectively for 2 years for disease activity [Disease Activity Score 28 (DAS28)], physical impairment (Health Assessment Questionnaire), total serum testosterone, non-sex hormone-binding globulin-bound testosterone, and luteinizing hormone (LH). A group of 131 healthy, medicine-free men served as controls for baseline hormone concentrations. Results The men with RA already had mean testosterone levels lower than controls early in the disease course. Patients older than 50 years also had significantly lower LH levels compared with controls, consistent with mild hypogonadotropic hypogonadism. In patients who responded to treatment at the 2-year followup the testosterone levels increased significantly. A decrease in DAS28 during the 2 years correlated significantly with increased testosterone levels (rs = –0.46, p = 0.006). LH levels were low and stable and did not correlate with disease activity. Conclusion In early RA, current inflammation seemed to affect the HPG axis, mainly at the gonadal rather than the hypothalamic-pituitary level. Prospective studies are indicated to determine if low HPG activity may be a cause rather than a consequence of a chronic inflammatory state.