Vplyv testosterónu na aktivitu ochorenia u pacientov s IBD

Autori: Hlavatý T., Krajčovičová A., Kollerová J., Koller T., Lešková Z., Šturdík I., Payer J.

Pracovisko: V. interná klinika Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava


INDTRODUCTION Sex differences in the incidence and progression of inflammatory bowel diseases (IBD) have been reported in observational studies. The effect of testosterone on the pathogenesis of IBD is unknow.

AIMS&METHODS The aim was to assess the serum concentration of testosterone in IBD male patients, to describe the prevalence of low serum concentration of testosterone and to investigate the effect of testosterone on disease activity. The cohort consisted of 113 consecutive IBD male patients (66 CD and 47 UC) examined at a tertiary IBD centre. Clinical and demographic characteristics of every patient were recorded i.e. age, duration of the disease, clinical behaviour, location of disease according to Montreal classification, IBD related surgeries, concomitant medications. We measured the morning serum concentration of testosterone, luteinising hormone, cortisol, ACTH, CRP, vitamin D in each patient. Disease activity was assessed by Harvey-Bradshaw Index (HBI) in CD patients and by partial Mayo score in UC patients. The prevalence of low serum concentration of testosterone below the cut-off 6nmol/l and cut-off  10nmol/l was assessed and risk factors analysed by univariate analysis.

RESULTS The median serum concentration of testosterone both in CD and UC male patients was 11nmol/l. The low serum concentration of testosterone with cut-offs  ≤6.0 nmol/l  and ≤10.0 nmol/l was noted in 4/113 (3.5%) IBD male patients (3 CD and 1UC) and in 38/113 (33.6%) (22CD and 16UC), respectively. We found significant negative correlation between age and testosterone in all IBD males (r2=0.067, p=0.006) and between CRP and testosterone in CD males (r2=0.073, p=0.028). No similar correlation was seen in UC patients. We did not observe any significant correlation between clinical activity although there was a trend towards significance in correlation of partial Mayo score and level serum concentration of testosterone in UC males (r2=0.076, p=0.061).  Patients who undergone appendectomy had significantly lower serum concentrations of testosterone in comparison to those who did not with median of 11.3 vs 8.4nmol/l (p = 0.005).

CONCLUSION The prevalence of low serum concentration of testosterone was observed in 3,5% (cut-off  ≤6.0 nmol/l) and 33,6% (cut-off ≤10.0 nmol/l) of IBD male patients. Serum concentration of testosterone correlated with age in all IBD patients and CRP in CD patients. The only risk factor of low serum level of testosterone was appendectomy.