Androgen deficiency and bone mineral density in men with rheumatoid arthritis.

[Guest guest]

Androgen deficiency and bone mineral density in men with rheumatoid arthritis.

Stafford L, Bleasel J, Giles A, Handelsman D

Department of Rheumatology, Forster Hospital, Redfern, Australia.

OBJECTIVE: To investigate the prevalence of osteopenia/osteoporosis in a group

of men with rheumatoid arthritis (RA); and to analyze the relationship between

sex hormone status and bone mineral density (BMD), taking into account disease

activity, disease duration, and corticosteroid intake. METHODS: Clinical and

demographic details were collected on 50 consecutive men with RA. BMD at the

lumbar spine and femoral neck were measured, together with plasma concentrations

of testosterone, sex hormone binding globulin, and luteinizing hormone. RESULTS:

The median age of patients was 67 years, with median disease duration 20 years.

Fourteen patients had never been treated with oral corticosteroids, the

remaining 36 received a range of prednisone doses over prolonged periods. Plasma

testosterone concentration was moderately reduced in 40% (< 10 nmol/l) and

severely reduced in 6% of men (< 8 nmol/l), but androgen deficiency was not

related to bone density or fractures. Spinal and femoral neck BMD was reduced in

38 and 71% of the men, respectively. Femoral neck BMD was related to age,

weight, disability status, and specific disease activity scores. The only

predictors of spinal BMD were pack-years of smoking and physician global

assessment. CONCLUSION: Reduced BMD is common among men with RA. The predictors

for spine and femoral neck BMD bear little direct relationship to blood

testosterone concentrations despite the relatively high prevalence of low

testosterone concentrations in this population. These findings are more

consistent with the possibility that low testosterone concentrations in men with

RA are a bystander effect of systemic inflammatory disease.

PMID: 11128664, UI: 21011280