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Autoimmune Diseases
Volume 2013, Article ID 593493, 13 pages
Research Article

Lower Serum Androstenedione Levels in Pre-Rheumatoid Arthritis versus Normal Control Women: Correlations with Lower Serum Cortisol Levels

1Department of Medicine, University of Illinois College of Medicine (UICOMP), One Illini Drive, Peoria, IL 61656, USA
2University of Illinois College of Medicine at Peoria, Peoria, IL 61656, USA
3Northwestern University (NWU), Feinberg School of Medicine, Chicago, IL 60611, USA

Received 28 February 2013; Accepted 23 April 2013

Academic Editor: Daniela Melchiorre

Copyright © 2013 Alfonse T. Masi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Serum adrenal androgens (AAs), including androstenedione (Δ4A) and dehydroepiandrosterone sulfate (DHEAS), have been reported to be lower in female rheumatoid arthritis (RA) patients with early disease. Few data are available on hormonal status of women before the onset of clinical rheumatoid arthritis (pre-RA). A broad baseline panel of serum adrenal and sex steroids was compared in 36 female pre-RA to 144 matched cohort control (CN) subjects to determine differences in their mean values and in patterns of hormonal correlations. Study subjects having lower versus higher baseline serum cortisol levels than the total group's mean value were also analyzed separately to investigate differences in their hormonal levels and correlational patterns. In total subjects, mean (±SE) Δ4A level (nmol/L) was lower ( ) in 28 pre-RA cases ( ) versus 108 CN ( ). The significant ( ) difference was restricted to 9 pre-RA versus 53 CN subjects having lower cortisol levels ( versus  nmol/L, resp.). In total subjects, no significant difference was found between study subjects in their bivariate correlations of the hormonal panel variables, unlike results found in the subgroups stratified by lower versus higher cortisol levels. A subgroup of pre-RA females may have relative adrenal cortical insufficiency, as reflected by lower Δ4A, especially observed among those subjects with lower cortisol levels.