Possible role of leptin, and tumor necrosis factor-alpha in hypoandrogenicity in patients with early rheumatoid arthritis

Hypoandrogenicity is common in men with rheumatoid arthritis who have lower levels of sex hormones such as testosterone and dehydroepiandrosterone sulphate. The fat tissue hormone leptin is stimulated by tumor necrosis factor alpha [TNF-alpha], and was found to be associated with hypoandrogenicity. To study the inter-relation between serum levels of TNF-alpha, leptin and androgens in early diagnosed RA. Serum levels of TNF-alpha, leptin, testosterone, and [DHEAS] hormones were measured by ELISA and compared in 40 men with early RA and 30 healthy volunteers. The mean serum leptin and TNF-alpha were significantly elevated in patients with RA compared to control group, and both of them were positively correlated with the disease activity score [DAS28]. Sex hormones [testosterone and DHEAS] were significantly decreased in male patients with RA compared to control group, and they were negatively correlated with serum TNF-alpha, leptin. Our data suggest that TNF-alpha, and leptin may be involved in hypoandrogenicity in patients with RA and that strategies aimed at interfering with leptin axis could represent innovative therapeutic tool for hypoandrogenicity in RA