Clinical features of systemic lupus erythematosus in men depending on testosterone level

Objective: to investigate the frequency of testosterone level lowering in men with systemic lupus erythematosus (SLE), and features of the SLE course, immunosuppressive therapy and metabolic disorders.

Material and methods. The cross-sectional continuous study included 38 men with SLE who were undergoing inpatient treatment in V.A. Nasonova Research Institute of Rheumatology. Patients' total testosterone level was determined, after which they were divided into groups with normal (>12 nmol/l) and reduced testosterone level. The patient groups were compared using the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of SLE, as well as purine and carbohydrate metabolism. Correlations between total testosterone level and some clinical and laboratory indicators were assessed.

Results and discussion. The frequency of testosterone deficiency in the studied group was 13.2%. Significant correlations of total testosterone level with prednisone dose (r=-0.56; p²; p=0.021) and dose of prednisone (15,0 [12,5; 20,0] vs 10,0 [5,0; 10,0] and also rarely took hydroxychloroquine compared to those with normal testosterone levels. In addition, in the clinical picture of SLE, there were less joint involvement, more frequent arterial hypertension and an increase in blood leukocytes level. In addition, a higher daily proteinuria value was found in patients with hypogonadism.

Conclusion. The relationship between testosterone level and prednisone dose in men with SLE has been demonstrated. Testosterone level and the presence of hypogonadism were not associated with the course and activity of SLE, but testosterone deficiency was associated with the presence of cardiometabolic disturbances as well as more pronounced proteinuria and less frequent joint involvement.

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