title: Androgen deficiency in male patients diagnosed with ANCA-associated vasculitis: a cause of fatigue and reduced health-related quality of life?
abstract: BACKGROUND
  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.
authors.forename: Janneke
authors.initials: J
authors.lastname: Tuin
authors.forename: Jan-Stephan F
authors.initials: JS
authors.lastname: Sanders
authors.forename: Birgit M
authors.initials: BM
authors.lastname: Buhl
authors.forename: André P
authors.initials: AP
authors.lastname: van Beek
authors.forename: Coen A
authors.initials: CA
authors.lastname: Stegeman
mesh_terms: D000368:Aged; D000728:Androgens / Q000172:deficiency* / Q000378:metabolism; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000378:metabolism* / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000378:metabolism; D005221:Fatigue / Q000378:metabolism / Q000503:physiopathology; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000172:deficiency* / Q000378:metabolism
chemical_list: D000728:Androgens; D013739:Testosterone; D002097:C-Reactive Protein
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