title: Androgen deficiency and dry eye syndrome in the aging male.
abstract: OBJECTIVE
  To evaluate the relationship between androgen levels and subjective and objective measures of dry eye syndrome (DES).
  
  
  METHODS
  A total of 263 male patients from the Miami Veterans Affairs Medical Center eye clinic aged ≥50 were recruited for this prospective cross-sectional study. Patients completed Dry Eye Questionnaire 5, underwent tear film evaluation, and had serum androgen levels measured. The correlations between androgen levels, DES composite scores, DES symptoms, and global, lipid, and aqueous tear film parameters were evaluated.
  
  
  RESULTS
  Two hundred sixty-three patients with a mean age of 69 (50-95) were examined. There was no linear association between composite DES scores (generated using latent class analysis) and androgen levels. However, eyes with high DES scores (0.95-1.0) had higher levels of sex hormone-binding globulin (P = 0.03) and lower levels of dehydroepiandrosterone sulfate (DHEAS) (P = 0.02), androstenedione (A) (P = 0.02), and androstane-3α,17β-diol glucuronide (P = 0.03) compared to eyes with intermediate (0.05-0.95) or low (0-0.05) scores. There were no strong correlations between tear film measures and androgen levels. Regarding global parameters, a weak inverse correlation was found between corneal staining and A (r = -0.17, P = 0.009). For lipid parameters, a weak correlation existed between tear breakup time (TBUT) and A (r = 0.15, P = 0.02). When considering aqueous and lipid deficiency independently, the association between TBUT and A existed only with aqueous tear deficiency (r = 0.66, P = 0.002). Regarding aqueous parameters, a weak correlation existed between Schirmer test and DHEAS (r = 0.13, P = 0.047) and A (r = 0.21, P = 0.001).
  
  
  CONCLUSIONS
  There was a weak correlation between higher levels of androstenedione and healthier global, lipid, and aqueous tear film parameters.
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, United States Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Azcarate
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, United States Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
authors.forename: Vincent D
authors.initials: VD
authors.lastname: Venincasa
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
authors.forename: William
authors.initials: W
authors.lastname: Feuer
authors.affiliation: Departments of Obstetrics and Gynecology and Preventive Medicine, University of Southern California, Los Angeles, California, United States.
authors.forename: Frank
authors.initials: F
authors.lastname: Stanczyk
authors.affiliation: Department of Pathology Department of Medicine Divisions of Oncology and Endocrinology, University of Miami, Miami, Florida, United States.
authors.forename: Andrew V
authors.initials: AV
authors.lastname: Schally
authors.affiliation: Miami Veterans Administration Medical Center, Miami, Florida, United States Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D000728:Androgens / Q000172:deficiency* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism*; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*
chemical_list: D000728:Androgens; D015415:Biomarkers
keywords: androgens; dry eye syndrome; meibomian gland