Androgen deficiency in male patients diagnosed with ANCA-associated vasculitis: a cause of fatigue and reduced health-related quality of life?

Arthritis Research & Therapy

Janneke Tuin³  Jan-Stephan F Sanders³  Birgit M Buhl²  André P van Beek¹  Coen A Stegeman³ 

[1] Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands

[2] Department of Internal Medicine, Division of Rheumatology, University of Groningen, University Medical Center Groningen, The Netherlands

[3] Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, The Netherlands

关键词: ANCA-associated vasculitis;    androgen deficiency;    testosterone;    physical functioning;    health-related quality of life (HRQOL);    Fatigue;   

Others  :  795444
DOI  :  10.1186/ar4297

 received in 2012-12-04, accepted in 2013-09-12,  发布年份 2013

【 摘 要 】

Introduction

Low testosterone levels in men are associated with fatigue, limited physical performance and reduced health-related quality of life (HRQOL); however, this relationship has never been assessed in patients with anti-neutrophil cytoplasmic antibodies (ANCA) -associated vasculitides (AAV). The aim of this study was to assess the prevalence of androgen deficiency and to investigate the role of testosterone in fatigue, limited physical condition and reduced HRQOL in men with AAV.

Methods

Male patients with AAV in remission were included in this study. Fatigue and HRQOL were assessed by the multi-dimensional fatigue inventory (MFI)-20 and RAND-36 questionnaires.

Results

Seventy male patients with a mean age of 59 years (SD 12) were included. Scores of almost all subscales of both questionnaires were significantly worse in patients compared to controls. Mean total testosterone and free testosterone levels were 13.8 nmol/L (SD 5.6) and 256 pmol/L (SD 102), respectively. Androgen deficiency (defined according to Endocrine Society Clinical Practice Guidelines) was present in 47% of patients. Scores in the subscales of general health perception, physical functioning and reduced activity were significantly worse in patients with androgen deficiency compared to patients with normal androgen levels. Testosterone and age were predictors for the RAND-36 physical component summary in multiple linear regression analysis. Testosterone, age, vasculitis damage index (VDI) and C-reactive protein (CRP) were associated with the MFI-20 subscale of general fatigue.

Conclusions

This study showed that androgen deficiency was present in a substantial number of patients with AAV. Testosterone was one of the predictors for physical functioning and fatigue. Testosterone may play a role in fatigue, reduced physical performance and HRQOL in male patients with AAV.

【 授权许可】

   
2013 Tuin et al.; licensee BioMed Central Ltd.

【 图 表 】

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