Chronic respiratory complications such as asthma, bronchiolitis obliterans, and chronic bronchitis are prevalent among individuals exposed to sulfur mustard (SM). This study investigates the hormonal changes associated with SM-induced respiratory disorders. A cross-sectional analysis was conducted involving 276 male participants exposed to SM during the Iraq-Iran war and 64 healthy controls. Serum levels of various hormones were measured. Testosterone, dehydroepiandrosterone sulfate (DHEA-S), luteinizing hormone (LH), DHEA-S/cortisol ratio, and DHEA-S/prolactin ratio were decreased in the SM-exposed group compared to the control group while prolactin level and prolactin/cortisol ratio were increased (P<0.05). The prolactin was increased in bronchiolitis obliterans, chronic bronchitis, and asthma compared to the control group while DHEA-S and DHEA-S/prolactin ratio were decreased in those disorders (P<0.05). The testosterone was only decreased in asthma, and DHEA-S/cortisol ratio was only decreased in bronchiolitis obliterans and chronic bronchitis compared to control and other disorders (P<0.05). The principle component analysis showed that the DHEA-S/cortisol and testosterone/cortisol ratios had the most contributing to interpatient variation in total SM-exposed patients in the principle component 1 (PC1). In patients with asthma and bronchiolitis obliterans, prolactin/cortisol and testosterone/cortisol ratios had the most contributing in PC1 while in patients with chronic bronchitis, the DHEA-S/cortisol and testosterone/cortisol ratios had the most contributing. Hormones including testosterone, prolactin, and DHEA-S or their ratios (DHEA-S/cortisol and DHEA-S/prolactin ratios) had the most alterations as delayed effects of sulfur mustard. Also, DHEA-S/cortisol, DHEA-S/prolactin, testosterone/cortisol, and prolactin/cortisol had the most contributing in changes of hormone profile for SM-induced pulmonary disorders. These data may suggest the best parameters for evaluating of hormone profile of SM-exposed people.
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