Are women with Sjögren's syndrome androgen-deficient?

Objective: We hypothesize that androgen deficiency is a critical etiologic factor in the pathogenesis of aqueous-deficient and evaporative dry eye in Sjögren's syndrome (SS). We investigated whether women with SS have a deficiency in total androgens. We also examined whether these patients have elevated serum concentrations of estrogens.

Methods: Blood was drawn from women with primary and secondary SS and age matched controls, and analyzed for steroid concentrations by gas and liquid chromatography-mass spectrometry.

Results: Our results show that women with SS are androgen-deficient. Concentrations of 5-androstene-3beta,17beta-diol (5-diol), dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), androsterone-glucuronide (ADT-G), and androstane-3a,17beta-diol-G (3alpha-diol-G) were all significantly reduced in SS sera relative to controls. In contrast, SS was not associated with significant alterations in the serum concentrations of testosterone, androstenedione, estrone, or 17beta-estradiol. These overall findings could not be attributed to the use of oral contraceptives or hormone replacement therapy, because the concentrations of 5-diol, DHEA, DHT, ADT-G and 3a-diol-G were also decreased in patients with SS compared to levels in control women who were not taking exogenous estrogens.

Conclusion: Our results show that women with SS are androgen-deficient.