Dehydroepiandrosterone sulphate serum levels in systemic sclerosis.

OBJECTIVE

To evaluate in a cohort of women with systemic sclerosis (SSc) the dehydroepiandrosterone sulphate (DHEAS) serum levels and their relationship with disease severity.

METHODS

DHEAS serum concentrations were measured by radioimmunoassay in 40 SSc patients and compared with those in 40 controls matched for sex and reproductive status. IL-2 sR alpha was evaluated as a disease activity index. A preliminary organ/system severity scale proposed by Medsger et al. in 1999 was used to evaluate disease severity.

RESULTS

Mean serum levels of DHEAS in SSc women of childbearing age were significantly lower than in controls (0.87 +/- 0.85 microgram/ml versus 2.75 +/- 0.42 micrograms/ml; p < 0.001). On the contrary, no difference was found between postmenopausal women and controls. A reduction below the 95% confidence limits was found in 10 out of 11 patients of childbearing age and in 8 out of 29 postmenopausal women, respectively. In 5 out of 11 patients of childbearing age taking steroids for their SSc (< 10 mg/daily) DHEAS levels were significantly lower than in patients not taking steroids (p = 0.01). On the contrary, 16 out of 29 postmenopausal women using steroids had lower DHEAS concentrations than in patients not taking steroids, although the difference was not statistically significant. There was no statistically significant difference in DHEAS levels between patients with diffuse or limited SSc, or between those with or without organ system involvement. No correlations were found either in pre- and post-menopausal steroid nonusers, or in limited and diffuse subsets, between DHEAS levels and age, postmenopausal years, disease duration, IL-2 sR alpha, disease organ/system severity scale.

CONCLUSION

Our data show that, as in other autoimmune diseases, low serum DHEAS is a feature of premenopausal SSc patients. More extensive prospective studies are needed to define the exact role of DHEAS dysregulation in SSc.