Salivary testosterone during the menstrual cycle in women with systemic lupus erythematosus

Abstract

In systemic lupus erythematosus (SLE) androgen abnormalities in men and women have been described, 1,2 although these findings have occurred in untreated women as well as in those undergoing treatment with glucocorticoids.3 Salivary testosterone is a well-established marker for circulating free testosterone concentrations in different clinical disorders and there is a consistency among laboratories in their values;' likewise salivary testosterone levels did not increase in premenopausal women with active untreated SLE, but decreased in women treated with glucocorticoids.8We studied salivary testosterone concentrations in the three phases of menstrual cycle from 13 SLE women that met 4 or more of the American Rheumatism Association's criteria. All patients were premenopausal, (mean age = 31 y, from 21-44), had quiescent disease and were receiving less than 20 mg of prednisone every other day. The clinical activity of the patients according to the SLEDAI was 3.4 ~ 1.6. None of the patients was taking immunosuppressive therapy or any other drug, and they reported having menstrual cycles of 28 ±5 d of length not varying more than 3 f 1 d. None of the patients had symptoms of Sjogren's syndrome.The saliva samples were collected at approximately 9:00 am into tubes prepared for this purpose without external stimulation; testosterone concentrations were measured with extraction procedure (Orion Diagnostica, Oulunsalo, Finland) with modifications in the sample volume. For the evaluation of the menstrual cycle of patients, LH and FSH serum concentrations were measured by RIA (DPC, Los Angeles, USA). Estradiol concentrations were measured by enzymeimmunoassay (ES-700 Boehringer Mannheim, Germany).Non-parametrical and paired Wilconson t-tests were used for the statistical analysis of data. A significant increase (P < 0.05) in salivary testosterone concentrations in both ovulatory peak (0.06 f 0.04 nmol/L) and luteal phase (0.07 zL 0.03 nmol/L) was observed respect to pholicular phase (0.05 0 .03 nmol/L) but no differences were observed between the ovulatory peak and the luteal phase. These results were decreased compared with those obtained in 72 healthy subjects age matched with patients (0.11 ::!: 0.04 nmol/L) in which the menstrual cycle was not studied. The levels of LH, FSH and estradiol were similar respect to the menstrual cycle from normal women. No correlation was observed between the duration of disease and the salivary testosterone concentrations, and similarly respect to anti Ro levels. As far as we know, there are no studies of the behaviour of testosterone in saliva during the menstrual cycle in SLE women treated with glucocorticoids. In healthy women, serum testosterone concentrations show how this hormone fluctuates during the menstrual cycle with higher levels in midcycle9 and in saliva of women with normal menstruations, testosterone values varying significantly during menstrual cycle. 10 An important point in our study is that salivary testosterone concentrations maintain a similar profile as in normal sub...