Correlations between spondylarthropathic inflammatory troubles and gonadal (androgenic) troubles in men. Study on 30 cases with a new methodological analysis.

Ankylosing spondylitis (AS) and spondylarthropathies (SAP), proposed immune diseases, present sexual preponderance: men are mostly affected. It is known that androgens are decreased in systemic immune disorders. We have investigated two aspects: gonadal--with 13 parameters, and entheso-osteoarthritic--with 10 parameters, by an original methodological semiquantitative analysis. All the parameters were divided into five degrees; each degree was pointed from 0 to 5, and the total and final scores were obtained. In this way differences and correlations could be performed between all 23 parameters. We have studied 30 SAP patients in inflammatory attack, 4 SAP patients out of the inflammatory attack and 16 control subjects; all were men and in fertile age. Between the gonadal status of SAP patients vs the control group there is a significant difference concerning: the degree of testosterone (1.81 vs 0.22, p < 0.005) and testes trophicity (1.5 vs 0.35, p < 0.01); marked differences have been recorded for integrative scores: total (12.18 vs 6.21, p < 0.02), final (1.07 vs 0.57, p < 0.01) and general degree score (1.7 vs 1.18, p < 0.01). Testosteronemia has been different, too: 7.38 vs 23.25 nmol/l, p < 0.01. Between SAP patients in and out of the inflammatory attack there are no significant differences. A significant positive correlation between gonadal axis status degree and entheso-osteoarthritic status degree has been obtained by Spearman rank test: r = 0.41, p < 0.05. Our new methodological analysis allows to change qualitative criteria in mathematical used quantitative data, for performing correlations between so different fields: rheumatological and endocrinological. SAP patients (in inflammatory attack, and out of the inflammatory attack) have a certain degree of hypogonadism, which does not represent a specific disease but suggests a specific spondylarthropathic background.