Gonadal and adrenal sex steroids in ankylosing spondylitis

The frequency and severity of ankylosing spondylitis (AS) shows a male preponderance. In search of an explanation, some authors have reported that serum androgen relative to estrogen levels are slightly elevated in AS patients compared to controls. However, more recent, better designed studies have found the serum testosterone, 17B-estradiol and androstenedione levels did not differ significantly between patients with AS and controls. The sex difference in AS prevalence remains intriguing and there may be a role for (normal male levels) androgens exerting an effect on immune processes involved in the pathogenesis of AS.