Androgen Deficiency Common Among Men With AAV

Tuin J, Sanders JSF, Buhl BM, et al., Androgen deficiency in male patients diagnosed with ANCA-associated vasculitis: a cause of fatigue and reduced health-related quality of life?Arthritis Research & Therapy (2013) 15:R117 doi:10.1186/ar4297, published online 12 September 2013  (Open access)

Almost half of men with ANCA-associated vasculitis and related autoimmune diseases may be androgen deficient, suffering fatigue, limited physical function, and other problems that negatively impact quality of life, according to a cross-sectional study from the Netherlands.

The study analyzed testosterone levels, health-related quality of life (HRQOL), and functioning among 70 men in remission from vasculitides associated with anti-neutrophil cytoplasmic antibodies – granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA).

Conforming with practice guidelines of the Endocrine Society, androgen deficiency was defined as total testosterone (TT) <10 nmol/L or 10-12 nmol/L in combination with free testosterone (FT) <0.30 pmol/L.

Among the cohort, 47% (n=33) were androgen-deficient, especially men >50 years, those with a longer disease duration (129 months vs. 75 months), greater vascular disease injury scores, as well as those who had been on higher doses of the immunosuppressant cyclophosphamide.

Compared to men with normal androgen levels, those with androgen deficiency (mean TT 9.8 nmol/L) had more fatigue and significantly lower scores for HRQOL and physical function. 

Because testosterone is one of the few modifiable factors, the researchers observe, it might be worth measuring androgen levels in men with ANCA-associated vasculitides and considering supplementation for those who are androgen-deficient.