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Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case-control study.

Pikwer, Mitra LU ; Giwercman, Aleksander LU ; Bergström, Ulf LU ; Nilsson, Jan-Åke LU ; Jacobsson, Lennart LU and Turesson, Carl LU (2014) In Annals of the Rheumatic Diseases 73(3). p.573-579
Abstract
OBJECTIVES: Rheumatoid arthritis (RA) is less common among men than women, and sex hormones have been suggested to play a part in the pathogenesis. Lower levels of testosterone have been demonstrated in men with RA, but it is not known if these changes precede the disease. METHODS: In a nested case-control study, using information and blood samples from a population-based health survey, we identified incident cases of RA by linking the cohort to local and national RA registers. Two controls for each validated case, matched for age, sex and year of screening, were selected from the health survey. Using stored blood samples, collected between 08:00 and 10:00 am after an overnight fast, we analysed levels of testosterone and other... (More)
OBJECTIVES: Rheumatoid arthritis (RA) is less common among men than women, and sex hormones have been suggested to play a part in the pathogenesis. Lower levels of testosterone have been demonstrated in men with RA, but it is not known if these changes precede the disease. METHODS: In a nested case-control study, using information and blood samples from a population-based health survey, we identified incident cases of RA by linking the cohort to local and national RA registers. Two controls for each validated case, matched for age, sex and year of screening, were selected from the health survey. Using stored blood samples, collected between 08:00 and 10:00 am after an overnight fast, we analysed levels of testosterone and other reproductive hormones. RESULTS: Serum was available from 104 cases (median time from screening to RA diagnosis 12.7 years (range 1-28); 73% rheumatoid factor (RF) positive at diagnosis or later) and 174 matched controls. In conditional logistic regression models, adjusted for smoking and body mass index, lower levels of testosterone were associated with subsequent development of RF-negative RA (OR 0.31 per SD, 95% CI 0.12 to 0.85), with a weaker association with RF-positive RA (OR 0.87 per SD; 95% CI 0.53 to 1.43). Levels of follicle-stimulating hormone were significantly increased in pre-RF-negative RA (p=0.02), but decreased in pre-RF-positive RA (p=0.02). CONCLUSIONS: Lower levels of testosterone were predictive of RF-negative RA, suggesting that hormonal changes precede the onset of RA and affect the disease phenotype. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
73
issue
3
pages
573 - 579
publisher
British Medical Association
external identifiers
  • pmid:23553100
  • wos:000330815300019
  • scopus:84893738314
ISSN
1468-2060
DOI
10.1136/annrheumdis-2012-202781
language
English
LU publication?
yes
id
9076b74b-c40a-4f0d-ab82-de1932df3d01 (old id 3734232)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23553100?dopt=Abstract
date added to LUP
2013-05-02 10:41:13
date last changed
2017-09-10 03:04:25
@article{9076b74b-c40a-4f0d-ab82-de1932df3d01,
  abstract     = {OBJECTIVES: Rheumatoid arthritis (RA) is less common among men than women, and sex hormones have been suggested to play a part in the pathogenesis. Lower levels of testosterone have been demonstrated in men with RA, but it is not known if these changes precede the disease. METHODS: In a nested case-control study, using information and blood samples from a population-based health survey, we identified incident cases of RA by linking the cohort to local and national RA registers. Two controls for each validated case, matched for age, sex and year of screening, were selected from the health survey. Using stored blood samples, collected between 08:00 and 10:00 am after an overnight fast, we analysed levels of testosterone and other reproductive hormones. RESULTS: Serum was available from 104 cases (median time from screening to RA diagnosis 12.7 years (range 1-28); 73% rheumatoid factor (RF) positive at diagnosis or later) and 174 matched controls. In conditional logistic regression models, adjusted for smoking and body mass index, lower levels of testosterone were associated with subsequent development of RF-negative RA (OR 0.31 per SD, 95% CI 0.12 to 0.85), with a weaker association with RF-positive RA (OR 0.87 per SD; 95% CI 0.53 to 1.43). Levels of follicle-stimulating hormone were significantly increased in pre-RF-negative RA (p=0.02), but decreased in pre-RF-positive RA (p=0.02). CONCLUSIONS: Lower levels of testosterone were predictive of RF-negative RA, suggesting that hormonal changes precede the onset of RA and affect the disease phenotype.},
  author       = {Pikwer, Mitra and Giwercman, Aleksander and Bergström, Ulf and Nilsson, Jan-Åke and Jacobsson, Lennart and Turesson, Carl},
  issn         = {1468-2060},
  language     = {eng},
  number       = {3},
  pages        = {573--579},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case-control study.},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2012-202781},
  volume       = {73},
  year         = {2014},
}