Are women with Sjögren's syndrome androgen-deficient?
OBJECTIVE
We hypothesize that androgen deficiency is a critical etiologic factor in the pathogenesis of aqueous-deficient and evaporative dry eye in Sjögren's syndrome (SS). We investigated whether women with SS have a deficiency in total androgens. We also examined whether these patients have elevated serum concentrations of estrogens.


METHODS
Blood was drawn from women with primary and secondary SS and age matched controls, and analyzed for steroid concentrations by gas and liquid chromatography-mass spectrometry.


RESULTS
Our results show that women with SS are androgen-deficient. Concentrations of 5-androstene-3beta,17beta-diol (5-diol), dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), androsterone-glucuronide (ADT-G), and androstane-3a,17beta-diol-G (3alpha-diol-G) were all significantly reduced in SS sera relative to controls. In contrast, SS was not associated with significant alterations in the serum concentrations of testosterone, androstenedione, estrone, or 17beta-estradiol. These overall findings could not be attributed to the use of oral contraceptives or hormone replacement therapy, because the concentrations of 5-diol, DHEA, DHT, ADT-G and 3a-diol-G were also decreased in patients with SS compared to levels in control women who were not taking exogenous estrogens.


CONCLUSIONS
Our results show that women with SS are androgen-deficient.
Sullivan
David A
DA
Schepens Eye Research Institute, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA. sullivan@vision.eri.harvard.edu
Bélanger
Alain
A
Cermak
Jennifer M
JM
Bérubé
René
R
Papas
Athena S
AS
Sullivan
Rose M
RM
Yamagami
Hiroko
H
Dana
M Reza
MR
Labrie
Fernand
F
D000728:Androgens / Q000097:blood / Q000172:deficiency*; D016022:Case-Control Studies; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008875:Middle Aged; D009994:Osmolar Concentration; D012859:Sjogren's Syndrome / Q000097:blood / Q000378:metabolism*
D000728:Androgens