Quality of life in men with rheumatoid arthritis and testosterone deficiency
T. S. Panevin,
A. M. Lila,
E. G. Zotkin,
A. S. Potapova,
S. I. Glukhova,
E. A. Strebkova,
M. V. Podryadnova,
M. K. Kurbanmagomedov https://doi.org/10.21518/ms2026-303
Abstract
Introduction. Low testosterone levels are common in men with rheumatoid arthritis (RA). Patients with RA and hypogonadism have higher levels, reflecting systemic inflammation. Both RA and hypogonadism can negatively impact quality of life.
Aim. To assess the impact of low testosterone levels on quality of life in men with RA.
Materials and methods. A cross-sectional study of 73 men diagnosed with RA was conducted. All patients had their total blood testosterone levels measured and were administered the HAQ, EQ-5D, and HADS questionnaires. A cross-sectional comparison of quantitative and qualitative parameters was performed between normal and low (≤12.0 nmol/L) total blood testosterone levels.
Results. Patients with hypogonadism and RA were characterized by lower quality of life indicators, which was reflected in the results of the HAQ questionnaires (1.59 ± 0.88 vs. 1.09 ± 0.87; p = 0.036), EQ-5D (0.52 [-0.01; 0.64] vs. 0.62 [0.52; 0.69]; p = 0.048), as well as the patient’s assessment of the general condition using VAS (70.0 [60.0; 80.0] vs. 60.0 [55.0; 70.0]; p = 0.039). The results of the HADS questionnaire were comparable in the studied subgroups. In the correlation analysis, the HAQ score correlated with RA activity according to DAS28CRP (r = 0.58; p < 0.001), ESR (ρ = 0.51; p < 0.001) and CRP (ρ = 0.55; p < 0.001), as well as the class of functional impairment (ρ = 0.26; p = 0.025), total testosterone (ρ = -0.3; p = 0.009) and hemoglobin (ρ = -0.48; p < 0.001). High RA activity (DAS28CRP ≥ 5.1), but not the presence of hypogonadism, as well as factors related to age and body weight, significantly increased the likelihood of having more negative results according to the HAQ questionnaire: OR 17.5; 95% CI 4.5–68.1 (p < 0.001) for HAQ ≥ 1.0 and OR 18.12; 95% CI 1.03–319.23 (p = 0.048) for HAQ ≥ 2.0.
Conclusion. Patients with RA and hypogonadism have a lower quality of life, which is due to the influence of inflammatory activity.
Keywords
rheumatoid arthritis,
inflammation,
testosterone,
hypogonadism,
androgen deficiency,
quality of life
Supporting agencies: This research was conducted as part of the State Assignment on the Personalization of Rheumatoid Arthritis Therapy to Sustain Stable Remission Based on Clinical and Molecular Biomarkers Predicting Response to the Baseline Therapy (No. 125020301268-4)
About the Authors
T. S. Panevin
Nasonova Research Institute of Rheumatology; Far Eastern State Medical University
Russian Federation
Russian Federation
Taras S. Panevin - Cand. Sci. (Med.), Researcher, Nasonova RIR; Associate Professor of Intermediate Level and Polyclinic Therapy Department with Endocrinology Course, Far Eastern SMU.
34а, Kashirskoe Shosse, Moscow, 115522; 35, Muravev-Amurskiy St., Khabarovsk, 680000
A. M. Lila
Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Aleksander M. Lila - Corr. Member RAS, Dr. Sci. (Med.), Professor, Director, Nasonova RIR; Head of the Department of Rheumatology, RMA of Continuous Professional Education.
34а, Kashirskoe Shosse, Moscow, 115522; 2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
E. G. Zotkin
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Evgeniy G. Zotkin - Dr. Sci. (Med.), 1st Deputy Director.
34а, Kashirskoe Shosse, Moscow, 115522
A. S. Potapova
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Alena S. Potapova - Cand. Sci. (Med.), Junior Researcher.
34а, Kashirskoe Shosse, Moscow, 115522
S. I. Glukhova
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Svetlana I. Glukhova - Cand. Sci. (Phys.&Math.), Senior Researcher.
34а, Kashirskoe Shosse, Moscow, 115522
E. A. Strebkova
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Ekaterina A. Strebkova - Cand. Sci. (Med.), Senior Researcher.
34а, Kashirskoe Shosse, Moscow, 115522
M. V. Podryadnova
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Maria V. Podryadnova - Cand. Sci. (Med.), Physician of the 2nd Rheumatology Department.
34а, Kashirskoe Shosse, Moscow, 115522
M. K. Kurbanmagomedov
Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Magomed K. Kurbanmagomedov - Physician of the 2nd Rheumatology Department.
34а, Kashirskoe Shosse, Moscow, 115522
References
1. Di Matteo A, Bathon JM, Emery P. Rheumatoid arthritis. Lancet. 2023;402(10416):2019–2033. https://doi.org/10.1016/S0140-6736(23)01525-8.
2. Safiri S, Kolahi AA, Hoy D, Smith E, Bettampadi D, Mansournia MA et al. Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis. 2019;78(11):1463–1471. https://doi.org/10.1136/annrheumdis2019-215920.
3. Cutolo M, Balleari E, Giusti M, Monachesi M, Accardo S. Sex hormone status of male patients with rheumatoid arthritis: evidence of low serum concentrations of testosterone at baseline and after human chorionic gonadotropin stimulation. Arthritis Rheum. 1988;31(10):1314–1317. https://doi.org/10.1002/art.1780311015.
4. Spector TD, Ollier W, Perry LA, Silman AJ, Thompson PW, Edwards A. Free and serum testosterone levels in 276 males: a comparative study of rheumatoid arthritis, ankylosing spondylitis and healthy controls. Clin Rheumatol. 1989;8(1):37–41. https://doi.org/10.1007/BF02031066.
5. Wen P, Wang Y, Yang M, Qiao X, Yang P, Hu S et al. Sex hormone imbalance and rheumatoid arthritis in American men: a cross-sectional analysis from NHANES 2011–2016. Front Immunol. 2024;15:1501257. https://doi.org/10.3389/fimmu.2024.1501257.
6. Dedov II, Mokrysheva NG, Melnichenko GA, Rozhivanov RV, Kamalov AA, Mkrtumyan АM et al. Draft of Russian Clinical Practice Guidelines “Male hypogonadism”. Obesity and Metabolism. 2021;18(4):496–507. (In Russ.) https://doi.org/10.14341/omet12817.
7. Panevin TS, Rozhivanov RV, Zotkin EG, Diatroptov ME, Glukhova SI, Samarkina EYu. Clinical and laboratory features of rheumatoid arthritis in men depending on testosterone levels. Problemy Endokrinologii. 2024;70(3):98–104 (In Russ.) https://doi.org/10.14341/probl13373.
8. Zitzmann M. Testosterone, mood, behaviour and quality of life. Andrology. 2020;8(6):1598–1605. https://doi.org/10.1111/andr.12867.
9. Maska L, Anderson J, Michaud K. Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment Questionnaire II (HAQ-II), Improved Health Assessment Questionnaire (Improved HAQ), and Rheumatoid Arthritis Quality of Life (RAQoL). Arthritis Care Res. 2011;63(Suppl. 11):S4–S13. https://doi.org/10.1002/acr.20620.
10. Karateev AE, Lila AM, Panevin TS, Potapova AS, Semashko AS, Bobkova AO, et al. Dynamics of patient reported outcomes during the use various biological disease-modifying antirheumatic drugs for rheumatoid arthritis. Rheumatology Science and Practice. 2022;60(4):427–437. (In Russ.) https://doi.org/10.47360/1995-4484-2022-427-437.
11. Cutolo M, Straub RH. Sex steroids and autoimmune rheumatic diseases: state of the art. Nat Rev Rheumatol. 2020;16(11):628–644. https://doi.org/10.1038/s41584-020-0503-4.
12. Mohamad NV, Wong SK, Wan Hasan WN, Jolly JJ, Nur-Farhana MF, Ima-Nirwana S, Chin KY. The relationship between circulating testosterone and inflammatory cytokines in men. Aging Male. 2019;22(2):129–140. https://doi.org/10.1080/13685538.2018.1482487.
13. Cutolo M, Sulli A, Capellino S, Villaggio B, Montagna P, Pizzorni C et al. Anti-TNF and sex hormones. Ann N Y Acad Sci. 2006;1069:391–400. https://doi.org/10.1196/annals.1351.037.
14. Baillargeon J, Al Snih S, Raji MA, Urban RJ, Sharma G, Sheffield-Moore M et al. Hypogonadism and the risk of rheumatic autoimmune disease. Clin Rheumatol. 2016;35(12):2983–2987. https://doi.org/10.1007/s10067-016-3330-x.
15. Yang DD, Krasnova A, Nead KT, Choueiri TK, Hu JC, Hoffman KE et al. Androgen deprivation therapy and risk of rheumatoid arthritis in patients with localized prostate cancer. Ann Oncol. 2018;29(2):386–391. https://doi.org/10.1093/annonc/mdx744.
16. Panevin TS, Zotkin EG, Dydykina IS, Potapova AS, Glukhova SI, Cherkasova MV, Diatroptov ME. Use of the AMS questionnaire to hypogonadism screening in men with rheumatoid arthritis. Meditsinskiy Sovet. 2025;19(5):113–119. (In Russ.) https://doi.org/10.21518/ms2025-059.
17. Tengstrand B, Carlström K, Hafström I. Bioavailable testosterone in men with rheumatoid arthritis-high frequency of hypogonadism. Rheumatology. 2002;41(3):285–289. https://doi.org/10.1093/rheumatology/41.3.285.
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For citations:
Panevin TS, Lila AM, Zotkin EG, Potapova AS, Glukhova SI, Strebkova EA, Podryadnova MV, Kurbanmagomedov MK. Quality of life in men with rheumatoid arthritis and testosterone deficiency. Meditsinskiy sovet = Medical Council. 2026;(12):202-208. (In Russ.) https://doi.org/10.21518/ms2026-303
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