Are women with Sjögren's syndrome androgen-deficient?

• Published in: Journal of rheumatology Vol. 30; no. 11; pp. 2413 - 2419
• Main Authors: SULLIVAN, David A, BELANGER, Alain, CERMAK, Jennifer M, BERUBE, René, PAPAS, Athena S, SULLIVAN, Rose M, YAMAGAMI, Hiroko, REZA DANA, M, LABRIE, Fernand
• Format: Journal Article
• Language: English
• Published: Toronto, ON Journal of Rheumatology Publishing 01-11-2003
• Subjects: Androgens - blood; Androgens - deficiency; Biological and medical sciences; Case-Control Studies; Female; Gas Chromatography-Mass Spectrometry; Humans; Medical sciences; Middle Aged; Osmolar Concentration; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sjogren's Syndrome - blood; Sjogren's Syndrome - metabolism; Endocrinopathy; Human; Immunopathology; Biochemical analysis; Androgen; Stomatology; Pathogenesis; Deficiency; Estrogen; Autoimmune disease; Sjögren syndrome; Eye disease; SJÖGREN'S SYNDROME ANDROGENS ESTROGENS DRY EYE; Systemic disease; Hormonal regulation; Female; Serum; Sex steroid hormone
• ISSN: 0315-162X; 1499-2752

We hypothesize that androgen deficiency is a critical etiologic factor in the pathogenesis of aqueous-deficient and evaporative dry eye in Sjögren's syndrome (SS). We investigated whether women with SS have a deficiency in total androgens. We also examined whether these patients have elevated serum concentrations of estrogens.
Blood was drawn from women with primary and secondary SS and age matched controls, and analyzed for steroid concentrations by gas and liquid chromatography-mass spectrometry.
Our results show that women with SS are androgen-deficient. Concentrations of 5-androstene-3beta,17beta-diol (5-diol), dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), androsterone-glucuronide (ADT-G), and androstane-3a,17beta-diol-G (3alpha-diol-G) were all significantly reduced in SS sera relative to controls. In contrast, SS was not associated with significant alterations in the serum concentrations of testosterone, androstenedione, estrone, or 17beta-estradiol. These overall findings could not be attributed to the use of oral contraceptives or hormone replacement therapy, because the concentrations of 5-diol, DHEA, DHT, ADT-G and 3a-diol-G were also decreased in patients with SS compared to levels in control women who were not taking exogenous estrogens.
Our results show that women with SS are androgen-deficient.