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Sex Steroid Hormones in Primary Sjögren's Syndrome
MICHAEL T. BRENNAN, VIDYA SANKAR, ROSE ANNE LEAKAN, MARGARET M. GRISIUS, MICHAEL T. COLLINS, PHILIP C. FOX, BRUCE J. BAUM, and STANLEY R. PILLEMER
ABSTRACT. Objective. To investigate the relationships between concentrations of sex hormones and measures of disease activity in patients with primary Sjögren's Syndrome (pSS). Methods. Fifty-four women were evaluated: 39 patients (age, Q1,Q3: 57.0 yrs; 46, 66) diagnosed with pSS and 15 patients (49.0 yrs; 45, 60) who did not meet diagnostic criteria for pSS. The following measures of disease activity were assessed: serological data [antinuclear antibody, rheumatoid factor, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum immunoglobulin levels (IgG, IgA, IgM), serum protein, anti-SSA, and anti-SSB], labial minor salivary gland focus score, salivary flow rates, and objective measures of eye dryness (fluorescein corneal staining and unstimulated Schirmer's I test). Spearman correlations were calculated between these indices of disease activity and serum levels of sex hormones: dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione, testosterone, dihydrotestosterone (DHT), estrone, estradiol, and sex hormone binding globulin (SHBG). Results. Numerous differences were noted between cases and controls with disease activity measures. All median values of sex steroid hormones were within the range of normal for pSS cases. Positive correlations were noted between testosterone and ESR (r = 0.36, p = 0.03), testosterone and serum protein (r = 0.37, p = 0.05), and testosterone and focus score (r = 0.44, p = 0.007). Negative correlations were present between SHBG and anti-SSA (r = –0.33, p = 0.05), SHBG and anti-SSB (r = –0.43, p = 0.009), and DHT and CRP (r = –0.41, p = 0.05). No correlations were noted between estrogens and measures of pSS disease activity. Conclusion. Higher levels of disease activity (ESR, serum protein, and focus score) were associated with higher concentrations of testosterone. No correlation between disease activity and estrogens was found. (J Rheumatol 2003;30:1267-71) Key Indexing Terms:
SJÖGREN'S SYNDROME
From the Gene Therapy and Therapeutics Branch (GTTB), National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH), Bethesda, Maryland; the Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania; and the Department of Oral Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA. M.T. Brennan, DDS, MHS, Clinical Research Core, NIDCR; V. Sankar, DMD, GTTB, NIDCR; R.A. Leakan, BSN, Clinical Center Nursing, NIH; M.M. Grisius, DDS, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine; M.T. Collins, MD, Craniofacial and Skeletal Diseases Branch, NIDCR; P.C. Fox, DDS, Department of Oral Medicine, Carolinas Medical Center; B.J. Baum, DMD, PhD; S.R. Pillemer, MD, GTTB, NIDCR. Address reprint requests to Dr. M.T. Brennan, Department of Oral Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA. Submitted February 1, 2002; revision accepted November 27, 2002. |