Possible role of leptin in hypoandrogenicity in patients with SLE and RA

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Ann Rheum Dis. 2004 Jul;63(7):809-16.

Possible role of leptin in hypoandrogenicity in patients with systemic

lupus erythematosus and rheumatoid arthritis.

Harle P, Pongratz G, Weidler C, Buttner R, Scholmerich J, Straub RH.

Laboratory of Neuro/endocrino/immunology, Department of Internal

Medicine I, University Hospital Regensburg, D-93042 Regensburg, Germany.

rainer.straub@...

BACKGROUND: Hypoandrogenicity is common in obesity and in chronic

inflammatory diseases such as systemic lupus erythematosus (SLE) and

rheumatoid arthritis (RA). Adrenal androgens such as androstenedione

(ASD) and dehydroepiandrosterone (DHEA) sulphate are low, which partly

depends on the influence of TNF in chronic inflammatory diseases. Leptin

is stimulated by TNF and is associated with hypoandrogenicity in

non-inflammatory conditions. OBJECTIVE: To study the interrelation

between serum levels of leptin and adrenal steroids in SLE and RA.

METHODS: In a retrospective study, serum levels of leptin, ASD, DHEA,

and 17-hydroxyprogesterone (17OHP) were measured by ELISA, and serum

levels of cortisol by radioimmunoassay in 30 patients with RA, 32 with

SLE, and 54 healthy control subjects (HS). RESULTS: In SLE and RA but

not HS, serum levels of ASD correlated negatively with serum levels of

leptin (p<0.01) independently of prior prednisolone treatment in

patients with SLE (p = 0.013) and tended to be independent of

prednisolone in patients with RA (p = 0.067). In a partial correlation

analysis, this interrelation remained significant after controlling for

daily prednisolone dose in both patient groups. In both patient groups,

serum leptin levels correlated negatively with the molar ratio of serum

ASD/serum cortisol and serum ASD/serum 17OHP, and positively with the

molar ratio of serum DHEA/serum ASD.

CONCLUSIONS: The negative correlation of serum leptin and ASD or,

particularly, ASD/17OHP, together with its known anti-androgenic effects

indicate that leptin is also involved in hypoandrogenicity in patients

with SLE and RA. Leptin may be an important link between chronic

inflammation and the hypoandrogenic state.

PMID: 15194576

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