Abstract
Testosterone serum levels may influence the lipoprotein metabolism and possibly atherogenic
risk. Our aim was to investigate the effects of long-term testosterone supplementation
in hypogonadal men on multiple lipoprotein markers. 18 Hypogonadal men were studied
before and after 3, 6, and 18 (n = 7) months of treatment with testosterone enanthate.
During treatment, serum testosterone and estradiol increased, reaching normal levels
(p < 0.0001 and 0.003, respectively). This was associated with a decrease in HDL cholesterol
(from 1.40 ± 0.10 mmol/l to 1.22 ± 0.08 mmol/l, p < 0.001) after six months at the
expense of HDL2 cholesterol (p < 0.01), as well as apoprotein A1 (from 139 ± 3.4 mg/dl
to 126 ± 3.0 mg/dl, p < 0.005). Hepatic lipase activity increased (p < 0.05) and correlated
positively with testosterone (r = 0.56, p < 0.02) and negatively with HDL cholesterol
(r = - 0.58, p < 0.02). Total and LDL cholesterol, triglycerides, and apoprotein B
did not increase. Among the seven patients who completed 18 months of treatment, triglycerides,
total cholesterol, LDL and HDL cholesterol, as well as total cholesterol/HDL cholesterol
ratio values did not differ from baseline while apoprotein A1 (p < 0.03) and HDL cholesterol
(p < 0.015) remained decreased and hepatic lipase unchanged. Restoration of testosterone
levels in hypogonadal men in this study did not reveal unfavorable changes based on
total cholesterol/HDL cholesterol and LDL cholesterol/apoprotein B ratios, which are
both atherogenic risk markers. Whether the changes in light of lipoprotein metabolism
will adversely influence cardiovascular risk over time remains to be determined.
Key words
Hypogonadism - Testosterone Substitution - Lipids - Lipoproteins - Hepatic Lipase
Transdermal testosterone replacement through genital skin. In: Nieschlag E, Behre HM (eds) Testosterone: action, deficiency and substitution. Berlin;
Springer Verlag 1990: 165 Measurement and clinical significance of high density lipoprotein cholesterol: subclases. In: Rifai N, Warnick GR, Dominiczak MH (ed) Handbook of lipoprotein testing. AACC
Press 1997: 251-266
gaberg@dbc.ffyb.uba.ar
