%0 Journal Article
%T Lower Serum Androstenedione Levels in Pre-Rheumatoid Arthritis versus Normal Control Women: Correlations with Lower Serum Cortisol Levels
%A Alfonse T. Masi
%A Kevin B. Elmore
%A Azeem A. Rehman
%A Robert T. Chatterton
%A Ned J. Goertzen
%A Jean C. Aldag
%J Autoimmune Diseases
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/593493
%X Serum adrenal androgens (AAs), including androstenedione (¦¤4A) and dehydroepiandrosterone sulfate (DHEAS), have been reported to be lower in female rheumatoid arthritis (RA) patients with early disease. Few data are available on hormonal status of women before the onset of clinical rheumatoid arthritis (pre-RA). A broad baseline panel of serum adrenal and sex steroids was compared in 36 female pre-RA to 144 matched cohort control (CN) subjects to determine differences in their mean values and in patterns of hormonal correlations. Study subjects having lower versus higher baseline serum cortisol levels than the total group's mean value were also analyzed separately to investigate differences in their hormonal levels and correlational patterns. In total subjects, mean (¡ÀSE) ¦¤4A level (nmol/L) was lower ( ) in 28 pre-RA cases ( ) versus 108 CN ( ). The significant ( ) difference was restricted to 9 pre-RA versus 53£¿CN subjects having lower cortisol levels ( versus £¿nmol/L, resp.). In total subjects, no significant difference was found between study subjects in their bivariate correlations of the hormonal panel variables, unlike results found in the subgroups stratified by lower versus higher cortisol levels. A subgroup of pre-RA females may have relative adrenal cortical insufficiency, as reflected by lower ¦¤4A, especially observed among those subjects with lower cortisol levels. 1. Introduction Relative insufficiency of adrenal glucocorticoid (GC) and androgenic-anabolic (AA) hormones has been suspected to increase the risk of developing rheumatoid arthritis (RA) and to contribute to its multifactorial neuroendocrine immune (NEI) pathogenesis [1¨C8]. The characteristic age- and sex-specific incidence patterns of RA support a possible constitutional deficiency of adrenal cortical or sex hormones in a subset of susceptible women. The female-to-male (F£¿:£¿M) risk ratio of persons developing RA is approximately 2£¿:£¿1 during the juvenile and older ages but is significantly increased to about 5£¿:£¿1 during the female reproductive years [9]. Of further note, risk of RA onset increases with age in adults, particularly among females. The preceding risk data imply that males have relative protection over females during all ages, but particularly in the younger and middle adult years [9]. A recent study indicated that early age at menopause (¡Ü45 years) was associated with the subsequent risk of developing RA [10]. The hazard remained significant after adjusting for smoking, educational level, and length of breastfeeding [10]. Available data imply that the woman¡¯s risk
%U http://www.hindawi.com/journals/ad/2013/593493/