The Investigation Of Serum Levels Of The Sex Hormone In Female Systemic Lupus Erythematosus Patients

Objective The long-term studies have shown that the serum level of sex hormone in SLE patients was clearly different from healthy women.However, the related conclusions were inconsistent, probably due to the influence of the menstrual cycle, or the small sample size. The aim of this study is to exclude the influence of menstrual cycle and identify the role of the sex hormone on the development of SLE.Methods257out-patient and in-patient females diagnosed SLE were enrolled from the Afficated Yan’an Hospital of Kunming Medical University.552healthy women were enrolled from health examination to be the control group. We designed a questionnaire according to the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI) and Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index(SLICC/ACRDI) to collect the clinical data of all patients. Then we used the technology of chemiluminescence immunoassay to determine the levels of serum estradiol (E2), progesterone (Pr), testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (PRL). And the SPSS17.0software was used to analysis the datum.Results1.The serum sex hormone levels between the SLE group and the healthy control group were generally compared. The level of follicle-stimulating hormone (FSH) in SLE group was significantly lower than the healthy females, and the difference was significant (P=0.026); the level of luteinizing hormone (LH) in SLE group was significantly higher than the healthy females group, and significant difference was showed (P=0.000); the difference of serum estradiol (E2) between the SLE group and the healthy females group was not statistically significant (P=0.219); the level of progesterone (Pr) in SLE group was significantly lower than the healthy females group, and the difference was significant (P=0.000); the level of testosterone (T) in SLE group was significantly lower than the healthy females group, and the difference was significant (P=0.000); the level of prolactin (PRL) in SLE group was significantly higher than the healthy females group, and the difference was significant (P=0.000). Comparison of hormone level in each menstrual cycle between SLE group and the healthy control group:in the follicular phase, serum follicle stimulating hormone (P=0.000), progesterone (P=0.000) and testosterone (P=0.000) in SLE group were respectively significantly lower than the healthy female group, while estradiol(P=0.000) and prolactin (P=0.000) in SLE group were respectively significantly higher than the healthy females group; in luteal phase, estradiol (P=0.000), progesterone (P=0.000) and testosterone (P=0.000) in SLE group were respectively significantly lower than the healthy control group, while prolactin (P=0.000) in SLE group was significantly higher than the healthy females group; in perimenopausal phrase, estradiol (P=0.000), progesterone (P=0.000) and testosterone (P=0.000) in SLE group were respectively significantly lower than the healthy control group, while luteinizing hormone (P=0.000) and prolactin (P=0.000) in SLE group were respectively significantly higher than the healthy control group; in menopausal phrase, follicle stimulating hormone (P=0.000)and testosterone(P=0.000) in SLE group were significantly lower than that the health control group.3. Analysis of Spearman correlation between sex hormone level and SLEDAI, SLICC of SLE patients:we found negative association between progesterone level and SLICC (r=-0.186, P=0.003). In follicular phrase, the progesterone level was negatively associated with SLICC (r=-0.259, P=0.001).Conclusions1. There were differences between the serum levels of sex hormones in SLE patients and healthy women especially in different menstrual cycles. The level of follicle stimulating hormone during the follicular phase and menopause in SLE females were lower than the healthy females; the level of luteinizing hormone during the follicular phase, luteal phase, perimenopausal period in SLE women were higher than the healthy women; the level of estradiol during follicular phase in SLE females were higher than healthy females, during perimenopausal in SLE women were lower the healthy women; the level of progesterone during the follicular phase, luteal phase and perimenopausal period in SLE females were lower than healthy females; the level of testosterone during the follicular phase, luteal phase, perimenopausal and menopausal in SLE women were lower than healthy women; the level of prolactin during the follicular phase, luteal phase and perimenopausal in SLE females were higher than the healthy females; it suggest the fluctuations of sex hormone levels in SLE patients induce the occurrences of systemic lupus erythematosus.2.In SLE group, serum progesterone is negatively associated with SLICC (r=-0.1860, P=0.003); in SLE group within the follicular phase, the level of serum progesterone has a negative correlation with SLICC(r=-0.259, P=0.001), suggesting a protective effect of progesterone on systemic lupus erythematosus.