Clinical and laboratory features of ankylosing spondylitis in men depending on testosterone levels

Objective – to study the incidence of hypogonadism in men with ankylosing spondylitis (AS) and evaluate its impact on AS and comorbidities.
Materials and methods. The one-time continuous study included 124 men with AS who were undergoing inpatient treatment at the V.A. Nasonova Research Institute of Rheumatology. Patients were assessed for total testosterone levels and subsequently divided into subgroups with normal (≥12.0 nmol/l) and reduced levels. An intergroup comparison was carried out on the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of AS, as well as on concomitant diseases. A correlation analysis was performed between the level of total testosterone and some clinical and laboratory parameters.
Results. The frequency of detected testosterone deficiency in the study group was 25.0%. With testosterone deficiency, a more frequent incidence of uveitis (45.2% vs 23.6%; p=0.022), as well as arterial hypertension (51.6% vs 30.1%; p=0.030) and type 2 diabetes mellitus (16.1% vs 4.3%; p=0.028). Testosterone deficiency was accompanied by higher levels of C-reactive protein (16.7 [3.2; 43.4] vs 5.0 [1.3; 17.4] mg/l; p=0.020), as well as higher frequency of increased ESR (45.2% vs 25.8%; p=0.043). There was a higher glucose level (5.75±1.19 vs 5.36±0.71 mmol/l; p=0.027) and more frequent impaired fasting glucose (25.8% vs 4.3%; p<0.001). A more frequent occurrence of hypercholesterolemia was revealed (43.3% vs 16.3%; p=0.010). Testosterone deficiency was accompanied by higher levels of uric acid (377.0±105.3 vs 324.0±67.7 µmol/l; p=0.002) and the incidence of hyperuricemia (67.9% vs 41.2%; p=0.014).
Conclusion. A high incidence of hypogonadism in patients with AS has been revealed. Testosterone levels and the presence of hypogonadism were not associated with the stage and activity of AS, but testosterone deficiency was accompanied by a higher incidence of uveitis, higher laboratory indicators of AS activity, and the incidence of concomitant metabolic disorders.

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