Influence of various modes of androgen substitution on serum lipids and lipoproteins in hypogonadal men

Jockenhövel, F.; Bullmann, Catharina; Schubert, Markus; Vogel, E.; Reinhardt, Walther; Reinwein, D.; Müller‐Wieland, Dirk; Krone, Wilhelm

doi:10.1016/s0026-0495(99)90056-2

Cited by 66 publications

(34 citation statements)

References 41 publications

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“…Although, as recommended, testosterone undecanoate was taken with meals, its absorption in our patients might have been reduced because the participants were required to comply with lifestyle modifications and their fat intake was low. However, the fact that oral testosterone increased plasma testosterone levels as well as slightly reduced HDL cholesterol, which is in line with the observations of other research groups [14][15][16], based on populations not having to limit their lipid intake, indicates that impaired absorption cannot solely explain a relatively weak effect of testosterone in our study.…”

Section: Discussionsupporting

confidence: 93%

“…Although observational studies show a consistent association of low testosterone with adverse lipid profiles [12,13], the question whether testosterone therapy exerts a beneficial effect plasma lipids remains uncertain. Moreover, in some studies, testosterone decreased circulating levels of HDL [14][15][16], considered to have a protective effect against coronary heart disease [17]. Taking into account the high prevalence of dyslipidemias in the general population [18], many men with LOH require treatment with lipid-lowering agents.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late‐Onset Hypogonadism and Atherogenic Dyslipidemia

Krysiak

Gilowski

2015

Cardiovascular Therapeutics

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SUMMARYIntroduction: Oral testosterone was found to reduce plasma levels of HDL cholesterol. No previous study has examined the effect of fibrates, known to increase HDL cholesterol, in patients with low testosterone levels requiring testosterone replacement. Aims: The study included three age-, weight-, and lipid-matched groups of older men with atherogenic dyslipidemia and late-onset hypogonadism, treated with oral testosterone undecanoate (120 mg daily, n = 15), micronized fenofibrate (200 mg daily, n = 15), or testosterone plus fenofibrate (n = 18). Plasma lipids, glucose homeostasis markers, as well as plasma levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, and fibrinogen were assessed before and after 16 weeks of therapy. Results: Apart from an increase in plasma testosterone and a reduction in HDL cholesterol, testosterone undecanoate tended to decrease hsCRP and to improve insulin sensitivity. Fenofibrate administered alone increased HDL cholesterol, reduced triglycerides, decreased insulin resistance, reduced circulating levels of uric acid, hsCRP, and fibrinogen, as well as increased plasma levels of homocysteine. The strongest effect on testosterone, HOMA1-IR, uric acid, hsCRP, and fibrinogen was observed if fenofibrate was administered together with testosterone. Testosterone-fenofibrate combination therapy was also devoid of unfavorable effect on HDL cholesterol and homocysteine. Conclusions: Our study shows that fenofibrate produces a stronger effect on cardiometabolic risk factors in men with late-onset hypogonadism and atherogenic dyslipidemia than oral testosterone undecanoate. The obtained results suggest that this group of patients may benefit the most from the combined treatment with oral testosterone undecanoate and micronized fenofibrate.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late‐Onset Hypogonadism and Atherogenic Dyslipidemia

Krysiak

Gilowski

2015

Cardiovascular Therapeutics

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“…Classical examples are the activators of hepatic lipase, such as anabolic steroids, nonaromatizable androgen derivatives, and androgenic progestogens. 15,16 Other mechanisms include inhibition of lipoprotein lipase (nonselective ␤-blockers 17 ), and inactivation of ABCA-I, such as has recently been reported for probucol. 18 Dietary factors, such as a high-carbohydrate, low-fat diet or diets rich in polyunsaturated fatty acids can lower HDL-C, 19 and cigarette smoking can also decrease HDL-C concentrations.…”

Section: Mild-to-moderate Hdl-c Deficiencymentioning

confidence: 92%

“…35 Testosterone compounds esterified at the 17-␤ position, such as those used to raise testosterone levels by intramuscular depot injection or as transdermal preparations have little or no effects on hepatic lipase or on HDL-C, whereas 17-alkylated compounds, such as oral methyltestosterone, have intermediary effects. 15 The degree of effect on hepatic lipase and HDL-C are thought to be related to the clearance rate of these drugs. The lowest HDL-C values encountered in subjects taking androgenic agents occur in weight-lifters taking high doses of multiple androgenic agents, typically combinations of testosterone with several anabolic steroids, such as stanazolol (Winstrol) and nandrolone decanoate (Decadurabolin) in repetitive cycles of 8 weeks or longer.…”

Section: Androgenic Anabolic Steroidsmentioning

confidence: 99%

Severe acquired (secondary) high-density lipoprotein deficiency

Goldberg

Mendez

2007

Journal of Clinical Lipidology

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“…Jockenhovel et al (31) showed that mesterolone 100 mg orally daily induces an unfavorable change in the lipid profile (Table 1). Actually, mesterolone increases LDL, CT and triglyceride (TG), and decreases HDL.…”

Section: Oral Androgenmentioning

confidence: 99%

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

Schleich

Legros

2004

European Journal of Endocrinology

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The decrease in serum bioavailable testosterone may be responsible for the catabolic sequelae noticed in the aging man (decrease in libido, decrease in muscle mass, osteoporosis and increase in adiposity). After a brief review of androgen and lipid metabolism as well as their modifications with aging, we discuss current knowledge of the effects of androgen substitution on the lipid profile in hypogonadal men. The results of studies concerning the effect of androgen substitution therapy on lipids are conflicting but might be favorable. The small decrease in high-density lipoprotein cholesterol observed when administering standard dosages of testosterone is accompanied by a significant decrease in total cholesterol (CT) and low-density lipoprotein cholesterol. A counterbalancing of these effects plausibly accounts for the absence of increase cardiovascular risk. The currently available preparations are oral, injectable or transdermal formulations of natural testosterone. The development of new androgen preparations that are more potent, metabolically stable and tissue-specific will improve therapeutic benefits and reduce side effects. European Journal of Endocrinology 151 415-424

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Influence of various modes of androgen substitution on serum lipids and lipoproteins in hypogonadal men

Cited by 66 publications

References 41 publications

The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late‐Onset Hypogonadism and Atherogenic Dyslipidemia

The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late‐Onset Hypogonadism and Atherogenic Dyslipidemia

Severe acquired (secondary) high-density lipoprotein deficiency

Effects of androgen substitution on lipid profile in the adult and aging hypogonadal male

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