Dehydroepiandrosterone sulphate serum levels in systemic sclerosis

Objective To evaluate in a cohort of women with systemic sclerosis (SSc) the dehydroe piandrosterone sulphate (DHEAS) serum levels and their relationship with di sease severity Methods DHEAS serum concentrations were measured by radioimmmunoassay in 40 SSc pat ients and compared with those in 40 controls matched for sex and reproducti ve status. IL-2 sR alpha was evaluated as a disease activity index. A preli minary organ/system severity scale proposed by Medsger et al. in 1999 was u sed to evaluate disease severity Results Mean serum levels of DHEAS in SSe women of childbearing age were significan tly lower than in controls (0.87 +/- 0.85 mug/ml versus 2. 75 + 0.42 mug/ml ; p < 0.001). On the contrary, no difference was found between postmenopaus al women and controls. A reduction below the 95% confidence limits was foun d in 10 out of 11 patients of childbearing age and in 8 out of 29 postmenop ausal women, respectively. In 5 out of 11 patients of childbearing age taki ng steroids for their SSc (< 10 mg/daily) DHEAS levels were significantly l ower than in patients not taking steroids (p = 0.01). On the contrary, 16 o ut of 29 postmenopausal women using steroids had lower DHEAS concentrations than in patients not taking steroids, although the difference was not stat istically significant. There was no statistically significant difference in DHEAS levels between patients with diffuse or limited SSc, or between thos e with or without organ system involvement. No correlations were found eith er in pre- and post-menopausal steroid nonusers, or in limited and diffuse subsets, between DHEAS levels and age, postmenopausal years, disease durati on, IL-2 sRa, disease organ/system severity scale. Conclusion Our data show that, as in other autoimmune diseases, low serum DHEAS is a f eature of premenopausal SSe patients. More extensive prospective studies ar e needed to define the exact role of DHEAS dysregulation in SSc.