Skip to main content
Top
Published in: BMC Oral Health 1/2021

Open Access 01-12-2021 | Stomatitis Aphthosa | Research

Comparison of the sex hormones’ serum level in women with recurrent aphthous stomatitis and healthy population: a cross-sectional study

Authors: Fatemeh Lavaee, Zahra Ranjbar, Mina Jalalian, Mohammad Amin Amiri

Published in: BMC Oral Health | Issue 1/2021

Login to get access

Abstract

Background

In this study, we aimed to evaluate the sex hormonal serum level in patients with recurrent aphthous stomatitis and compare them with healthy participants.

Methods

This cross-sectional study was done on patients with recurrent aphthous stomatitis who had referred to Shiraz Dental Faculty, Oral and Maxillofacial Medicine Department during 2018–2019. The non -menopause women with recurrence of at least 3 lesions per year were enrolled in this study. The mean serum level of FSH, LH, PRL (prolactin), testosterone, DHT (Dihydrotestosterone), DHEA-S (Dehydroepiandrosterone sulfate), estradiol and progesterone of 30 participants in each group of case and control were measured and compared. The data were analyzed by SPSS version 18 and independent T-test, Mann–Whitney U test, Spearman’s correlation coefficient test, Chi-square test and Fisher’s test.

Results

The mean serum level of DHEA-S in patients with recurrent aphthous stomatitis (RAS) was significantly lower than the control group (p value = 0.02). In addition to DHEA-S, the mean serum level of testosterone was lower in the evaluation group although this difference was not significant (p value = 0.057). Considering the effect of age on the mean serum level of sex hormones, our results revealed that only DHEA-S mean serum level was decreased by increasing the age of participants in patients with RAS (p value = 0.018). The number of participants with abnormal range of testosterone (p value < 0.0001) and progesterone (p value = 0.037) serum level was significantly more in patients with RAS. The frequency of RAS in a year did not show a significant relationship with the serum level of the evaluated hormones.

Conclusion

The patients with RAS had a lower serum level of DHEA-S. The mean serum level of testosterone and progesterone was significantly abnormal in RAS patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Balan U, Gonsalves N, Jose M, Girish K. Symptomatic changes of oral mucosa during normal hormonal turnover in healthy young menstruating women. J Contemp Dent Pract. 2012;13(2):178–81.CrossRef Balan U, Gonsalves N, Jose M, Girish K. Symptomatic changes of oral mucosa during normal hormonal turnover in healthy young menstruating women. J Contemp Dent Pract. 2012;13(2):178–81.CrossRef
2.
go back to reference Giannetti L, Murri ADD, Lo LM. Recurrent aphtous stomatitis. Minerva Stomatol. 2018;67(3):125–8.PubMed Giannetti L, Murri ADD, Lo LM. Recurrent aphtous stomatitis. Minerva Stomatol. 2018;67(3):125–8.PubMed
3.
go back to reference Izakovicova Holla L, Valova S, Borilova Linhartova P, Bartova J, Petanova J, Kuklinek P, et al. Association study of interleukin-1 family, interleukin-6, and its receptor gene polymorphisms in patients with recurrent aphthous stomatitis. J Oral Pathol Med. 2017;46(10):1030–5.PubMed Izakovicova Holla L, Valova S, Borilova Linhartova P, Bartova J, Petanova J, Kuklinek P, et al. Association study of interleukin-1 family, interleukin-6, and its receptor gene polymorphisms in patients with recurrent aphthous stomatitis. J Oral Pathol Med. 2017;46(10):1030–5.PubMed
4.
go back to reference Suter VGA, Sjolund S, Bornstein MM. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review. Lasers Med Sci. 2017;32(4):953–63.CrossRef Suter VGA, Sjolund S, Bornstein MM. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review. Lasers Med Sci. 2017;32(4):953–63.CrossRef
5.
go back to reference González DA, Díaz BB, Pérez MdCR, Hernández AG, Chico BND, de León AC. Sex hormones and autoimmunity. Immunol Lett. 2010;133(1):6–13.CrossRef González DA, Díaz BB, Pérez MdCR, Hernández AG, Chico BND, de León AC. Sex hormones and autoimmunity. Immunol Lett. 2010;133(1):6–13.CrossRef
6.
go back to reference Levin ER. Minireview: extranuclear steroid receptors: roles in modulation of cell functions. Mol Endocrinol. 2011;25(3):377.CrossRef Levin ER. Minireview: extranuclear steroid receptors: roles in modulation of cell functions. Mol Endocrinol. 2011;25(3):377.CrossRef
7.
go back to reference Maingat FG, Polyak MJ, Paul AM, Vivithanaporn P, Noorbakhsh F, Ahboucha S, et al. Neurosteroid-mediated regulation of brain innate immunity in HIV/AIDS: DHEA-S suppresses neurovirulence. FASEB J. 2013;27(2):725–37.CrossRef Maingat FG, Polyak MJ, Paul AM, Vivithanaporn P, Noorbakhsh F, Ahboucha S, et al. Neurosteroid-mediated regulation of brain innate immunity in HIV/AIDS: DHEA-S suppresses neurovirulence. FASEB J. 2013;27(2):725–37.CrossRef
8.
go back to reference Giannoni E, Guignard L, Reymond MK, Perreau M, Roth-Kleiner M, Calandra T, et al. Estradiol and progesterone strongly inhibit the innate immune response of mononuclear cells in newborns. Infect Immun. 2011;79(7):2690–8.CrossRef Giannoni E, Guignard L, Reymond MK, Perreau M, Roth-Kleiner M, Calandra T, et al. Estradiol and progesterone strongly inhibit the innate immune response of mononuclear cells in newborns. Infect Immun. 2011;79(7):2690–8.CrossRef
9.
go back to reference Fijak M, Schneider E, Klug J, Bhushan S, Hackstein H, Schuler G, et al. Testosterone replacement effectively inhibits the development of experimental autoimmune orchitis in rats: evidence for a direct role of testosterone on regulatory T cell expansion. J Immunol. 2011;186(9):5162–72.CrossRef Fijak M, Schneider E, Klug J, Bhushan S, Hackstein H, Schuler G, et al. Testosterone replacement effectively inhibits the development of experimental autoimmune orchitis in rats: evidence for a direct role of testosterone on regulatory T cell expansion. J Immunol. 2011;186(9):5162–72.CrossRef
10.
go back to reference Lewis JA, Jonsson B, Kreutz G, Sampaio C, van Zwieten-Boot B. Placebo-controlled trials and the Declaration of Helsinki. Lancet. 2002;359(9314):1337–40.CrossRef Lewis JA, Jonsson B, Kreutz G, Sampaio C, van Zwieten-Boot B. Placebo-controlled trials and the Declaration of Helsinki. Lancet. 2002;359(9314):1337–40.CrossRef
11.
go back to reference Straub RH, Weidler C, Demmel B, Herrmann M, Kees F, Schmidt M, et al. Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus. Ann Rheum Dis. 2004;63(8):961–8.CrossRef Straub RH, Weidler C, Demmel B, Herrmann M, Kees F, Schmidt M, et al. Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus. Ann Rheum Dis. 2004;63(8):961–8.CrossRef
12.
go back to reference Forsblad-d’Elia H, Carlsten H, Labrie F, Konttinen YT, Ohlsson C. Low serum levels of sex steroids are associated with disease characteristics in primary Sjogren’s syndrome; supplementation with dehydroepiandrosterone restores the concentrations. J Clin Endocrinol Metab. 2009;94(6):2044–51.CrossRef Forsblad-d’Elia H, Carlsten H, Labrie F, Konttinen YT, Ohlsson C. Low serum levels of sex steroids are associated with disease characteristics in primary Sjogren’s syndrome; supplementation with dehydroepiandrosterone restores the concentrations. J Clin Endocrinol Metab. 2009;94(6):2044–51.CrossRef
13.
go back to reference Laine M, Porola P, Udby L, Kjeldsen L, Cowland JB, Borregaard N, et al. Low salivary dehydroepiandrosterone and androgen-regulated cysteine-rich secretory protein 3 levels in Sjögren’s syndrome. Arthritis Rheum. 2007;56(8):2575–84.CrossRef Laine M, Porola P, Udby L, Kjeldsen L, Cowland JB, Borregaard N, et al. Low salivary dehydroepiandrosterone and androgen-regulated cysteine-rich secretory protein 3 levels in Sjögren’s syndrome. Arthritis Rheum. 2007;56(8):2575–84.CrossRef
14.
go back to reference Masi A. Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Clin Exp Rheumatol. 1995;13(2):227–40.PubMed Masi A. Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Clin Exp Rheumatol. 1995;13(2):227–40.PubMed
15.
go back to reference Kroboth PD, Salek FS, Pittenger AL, Fabian TJ, Frye RF. DHEA and DHEA-S: a review. J Clin Pharmacol. 1999;39(4):327–48.CrossRef Kroboth PD, Salek FS, Pittenger AL, Fabian TJ, Frye RF. DHEA and DHEA-S: a review. J Clin Pharmacol. 1999;39(4):327–48.CrossRef
16.
go back to reference Straub R, Zeuner M, Antoniou E, Schölmerich J, Lang B. Dehydroepiandrosterone sulfate is positively correlated with soluble interleukin 2 receptor and soluble intercellular adhesion molecule in systemic lupus erythematosus. J Rheumatol. 1996;23(5):856–61.PubMed Straub R, Zeuner M, Antoniou E, Schölmerich J, Lang B. Dehydroepiandrosterone sulfate is positively correlated with soluble interleukin 2 receptor and soluble intercellular adhesion molecule in systemic lupus erythematosus. J Rheumatol. 1996;23(5):856–61.PubMed
17.
go back to reference Taylor MK, Sausen KP, Potterat EG, Mujica-Parodi LR, Reis JP, Markham AE, et al. Stressful military training: endocrine reactivity, performance, and psychological impact. Aviat Space Environ Med. 2007;78(12):1143–9.CrossRef Taylor MK, Sausen KP, Potterat EG, Mujica-Parodi LR, Reis JP, Markham AE, et al. Stressful military training: endocrine reactivity, performance, and psychological impact. Aviat Space Environ Med. 2007;78(12):1143–9.CrossRef
18.
go back to reference Michel AR, Luz C, Wudarcki S, Cherubini K, de Figueiredo MAZ, Salum FG. Cortisol and dehydroepiandrosterone salivary levels, stress and anxiety in patients with recurrent aphthous stomatitis. Revista Odonto Ciência. 2015;30(4):120–5.CrossRef Michel AR, Luz C, Wudarcki S, Cherubini K, de Figueiredo MAZ, Salum FG. Cortisol and dehydroepiandrosterone salivary levels, stress and anxiety in patients with recurrent aphthous stomatitis. Revista Odonto Ciência. 2015;30(4):120–5.CrossRef
19.
go back to reference Girardi C, Luz C, Cherubini K, de Figueiredo MAZ, Nunes MLT, Salum FG. Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus. Arch Oral Biol. 2011;56(9):864–8.CrossRef Girardi C, Luz C, Cherubini K, de Figueiredo MAZ, Nunes MLT, Salum FG. Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus. Arch Oral Biol. 2011;56(9):864–8.CrossRef
20.
go back to reference Lennartsson A-K, Kushnir MM, Bergquist J, Jonsdottir IH. DHEA and DHEA-S response to acute psychosocial stress in healthy men and women. Biol Psychol. 2012;90(2):143–9.CrossRef Lennartsson A-K, Kushnir MM, Bergquist J, Jonsdottir IH. DHEA and DHEA-S response to acute psychosocial stress in healthy men and women. Biol Psychol. 2012;90(2):143–9.CrossRef
21.
go back to reference Maheswaran T, Yamunadevi A, Ilayaraja V, Dineshshankar J, Yoithapprabhunath TR, Ganapathy N. Correlation between the menstrual cycle and the onset of recurrent aphthous stomatitis. J Indian Acad Dent Spec Res. 2015;2(1):25.CrossRef Maheswaran T, Yamunadevi A, Ilayaraja V, Dineshshankar J, Yoithapprabhunath TR, Ganapathy N. Correlation between the menstrual cycle and the onset of recurrent aphthous stomatitis. J Indian Acad Dent Spec Res. 2015;2(1):25.CrossRef
22.
go back to reference Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008;46(3):198–206.CrossRef Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008;46(3):198–206.CrossRef
23.
go back to reference Soetiarto F, Maria A, Utami S. The relationship between recurrent aphthae stomatitis and reproductive hormones levels. Bull Penelit Kesehat. 2009;37(2):79–86. Soetiarto F, Maria A, Utami S. The relationship between recurrent aphthae stomatitis and reproductive hormones levels. Bull Penelit Kesehat. 2009;37(2):79–86.
24.
go back to reference Sunardi SU, Rahardjo TBW, Baziad A, Auerkari EI. The role of estrogen receptor beta on severity of recurrent aphthous stomatitis (RAS). J Int Dent Med Res. 2017;10:711–4. Sunardi SU, Rahardjo TBW, Baziad A, Auerkari EI. The role of estrogen receptor beta on severity of recurrent aphthous stomatitis (RAS). J Int Dent Med Res. 2017;10:711–4.
25.
go back to reference Klump KL, Keel PK, Racine SE, Burt SA, Neale M, Sisk CL, et al. The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. J Abnorm Psychol. 2013;122(1):131.CrossRef Klump KL, Keel PK, Racine SE, Burt SA, Neale M, Sisk CL, et al. The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. J Abnorm Psychol. 2013;122(1):131.CrossRef
26.
go back to reference Van Vollenhoven R, Park J, Genovese M, West J, McGuire J. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8(3):181–7.CrossRef Van Vollenhoven R, Park J, Genovese M, West J, McGuire J. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8(3):181–7.CrossRef
27.
go back to reference Gordon C, Wallace D, Shinada S, Kalunian K, Forbess L, Braunstein G, et al. Testosterone patches in the management of patients with mild/moderate systemic lupus erythematosus. Rheumatology. 2008;47(3):334–8.CrossRef Gordon C, Wallace D, Shinada S, Kalunian K, Forbess L, Braunstein G, et al. Testosterone patches in the management of patients with mild/moderate systemic lupus erythematosus. Rheumatology. 2008;47(3):334–8.CrossRef
28.
go back to reference Pikwer M, Giwercman A, Bergström U, Nilsson J-Å, Jacobsson LT, Turesson C. Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case–control study. Ann Rheum Dis. 2014;73(3):573–9.CrossRef Pikwer M, Giwercman A, Bergström U, Nilsson J-Å, Jacobsson LT, Turesson C. Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case–control study. Ann Rheum Dis. 2014;73(3):573–9.CrossRef
29.
go back to reference Ziehn MO, Avedisian AA, Dervin SM, Umeda EA, O’Dell TJ, Voskuhl RR. Therapeutic testosterone administration preserves excitatory synaptic transmission in the hippocampus during autoimmune demyelinating disease. J Neurosci. 2012;32(36):12312–24.CrossRef Ziehn MO, Avedisian AA, Dervin SM, Umeda EA, O’Dell TJ, Voskuhl RR. Therapeutic testosterone administration preserves excitatory synaptic transmission in the hippocampus during autoimmune demyelinating disease. J Neurosci. 2012;32(36):12312–24.CrossRef
30.
go back to reference Melcangi RC, Garcia-Segura LM, Mensah-Nyagan AG. Neuroactive steroids: state of the art and new perspectives. Cell Mol Life Sci: CMLS. 2008;65(5):777–97.CrossRef Melcangi RC, Garcia-Segura LM, Mensah-Nyagan AG. Neuroactive steroids: state of the art and new perspectives. Cell Mol Life Sci: CMLS. 2008;65(5):777–97.CrossRef
31.
go back to reference Haring R, Hannemann A, John U, Radke D, Nauck M, Wallaschofski H, et al. Age-specific reference ranges for serum testosterone and androstenedione concentrations in women measured by liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2012;97(2):408–15.CrossRef Haring R, Hannemann A, John U, Radke D, Nauck M, Wallaschofski H, et al. Age-specific reference ranges for serum testosterone and androstenedione concentrations in women measured by liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2012;97(2):408–15.CrossRef
32.
go back to reference Assad S, Khan HH, Ghazanfar H, Khan ZH, Mansoor S, Rahman MA, et al. Role of sex hormone levels and psychological stress in the pathogenesis of autoimmune diseases. Cureus. 2017;9(6):e1315.PubMedPubMedCentral Assad S, Khan HH, Ghazanfar H, Khan ZH, Mansoor S, Rahman MA, et al. Role of sex hormone levels and psychological stress in the pathogenesis of autoimmune diseases. Cureus. 2017;9(6):e1315.PubMedPubMedCentral
Metadata
Title
Comparison of the sex hormones’ serum level in women with recurrent aphthous stomatitis and healthy population: a cross-sectional study
Authors
Fatemeh Lavaee
Zahra Ranjbar
Mina Jalalian
Mohammad Amin Amiri
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2021
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-021-01812-9

Other articles of this Issue 1/2021

BMC Oral Health 1/2021 Go to the issue