Panevin T S, Rozhivanov R V, Zotkin E G, Diatroptov M E, Glukhova S I, Samarkina E Yu
V.A. Nasonova Research Institute of Rheumatology; The Far Eastern State Medical University.
Endocrinology Research Centre.
Probl Endokrinol (Mosk). 2023 Nov 2;70(3):98-104. doi: 10.14341/probl13373.
It has been suggested that the presence of chronic immunoinflammatory rheumatic disease (CIRD) may be a factor that increases the likelihood of developing hypogonadism syndrome, and conversely, the presence of uncompensated testosterone deficiency may predispose to a greater risk of developing or more severe course of ICRD.
To study the incidence of hypogonadism in men with rheumatoid arthritis (RA) and evaluate its impact on the course of RA and concomitant diseases.
A one-time continuous study included 170 men with RA who were undergoing inpatient treatment at the Federal State Budgetary Institution NIIR named after. V.A. Nasonova. Patients were assessed for total testosterone levels and subsequently divided into subgroups with normal (>12 nmol/l) and reduced levels. An intergroup comparison was carried out on the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of RA, as well as the state of purine and carbohydrate metabolism. A correlation analysis was performed between the level of total testosterone and some clinical and laboratory parameters.
The frequency of detected testosterone deficiency in the study group was 24.1%. Significant correlations were noted between the level of total testosterone and body mass index (r=-0.29), the level of blood uric acid (r=-0.19) and C-reactive protein (r=-0.18). Patients with hypogonadism compared to the group with normal testosterone levels were characterized by higher body mass index (29.3±5.6 vs 26.3±4.0 kg/m2; p<0.001), glucose levels (6.95±7 .85 mmol/l vs 5.42±1.13 mmol/l; p=0.034) and uric acid (354.6±110.7 vs 317.5±84.8 µmol/l; p=0.03) blood. In addition, patients with hypogonadism were more likely to suffer from obesity (41.6% vs 15.7%; p=0.001) and diabetes mellitus (21.6% vs 10.2%; p=0.075) without a statistically significant difference, and also had higher ESR (46.5±42.2 vs 31.0±30.9 mm/h; p=0.012). A more frequent occurrence of anemia was noted in hypogonadism (32.4% vs 16.7%; p=0.041).
Testosterone levels and the presence of hypogonadism were not associated with the stage and activity of RA, however, testosterone deficiency was accompanied by a more frequent development of overweight and obesity, and a deterioration in purine and carbohydrate metabolism.
有人提出，慢性免疫炎性风湿性疾病（CIRD）的存在可能是增加性腺功能减退综合征发生可能性的一个因素，反之，未代偿的睾酮缺乏可能使发生ICRD的风险更高或病程更严重。
研究类风湿关节炎（RA）男性患者性腺功能减退的发生率，并评估其对RA病程及伴发疾病的影响。
一项一次性连续性研究纳入了170例在以V.A.纳索诺娃命名的联邦国家预算机构全俄风湿病研究所接受住院治疗的RA男性患者。对患者的总睾酮水平进行评估，随后分为睾酮水平正常（>12 nmol/l）和降低的亚组。对临床风湿病实践中用于评估RA分期、活动度及其他医学和人口统计学特征以及嘌呤和碳水化合物代谢状态的主要指标进行组间比较。对总睾酮水平与一些临床和实验室参数进行相关性分析。
研究组中检测到的睾酮缺乏频率为24.1%。总睾酮水平与体重指数（r=-0.29）、血尿酸水平（r=-0.19）和C反应蛋白（r=-0.18）之间存在显著相关性。与睾酮水平正常的组相比，性腺功能减退患者的特征为体重指数更高（29.3±5.6 vs 26.3±4.0 kg/m2；p<0.001）、血糖水平更高（6.95±7.85 mmol/l vs 5.42±1.13 mmol/l；p=0.034）和血尿酸水平更高（354.6±110.7 vs 317.5±84.8 µmol/l；p=0.03）。此外，性腺功能减退患者更易患肥胖症（41.6% vs 15.7%；p=0.001）和糖尿病（21.6% vs 10.2%；p=0.075），差异无统计学意义，且血沉更高（46.5±42.2 vs 31.0±30.9 mm/h；p=0.012）。性腺功能减退患者贫血的发生率更高（32.4% vs 16.7%；p=0.041）。
睾酮水平及性腺功能减退的存在与RA的分期和活动度无关，然而，睾酮缺乏伴随着超重和肥胖的更频繁发生以及嘌呤和碳水化合物代谢的恶化。
