Quality of life in men with rheumatoid arthritis and testosterone deficiency

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.