Plasma Cortisol and Testosterone in Hypercholesterolaemia Treated with Clofibrate and Lovastatin

Abstract

Plasma testosterone and cortisol concentrations were measured in 32 familial heterozygous hypercholesterolaemic subjects, aged 40-45 years. The subjects were divided into two groups of 16, each containing eight men and eight women. The women had normal menstrual cycles. After a period on placebo, one group of patients was given 40 mg/day lovastatin and the other was given 1500 mg/day clofibrate. Both drugs significantly reduced the plasma cholesterol concentration, however, unlike clofibrate, lovastatin did not decrease plasma levels of testosterone and cortisol. The response to stimulation by adrenocorticotrophic hormone of plasma cortisol and urinary 17-hydroxy levels was significantly reduced by treatment with clofibrate, but unchanged by lovastatin. The different effects produced by the two drugs probably reflect different mechanisms and sites of action.

Effects of Evolocumab on Vitamin E and Steroid Hormone Levels

“…35,36 The impact of statins on adrenal function has been studied in multiple populations with a wide variety of statins. 23,[25][26][27][28][29]31,32,[37][38][39][40][41][42][43][44][45] None of these studies showed clinically relevant impairment of adrenal function, secondary to statin therapy. Patients with heterozygous or homozygous familial hypercholesterolemia could also theoretically be at increased risk of adrenal dysfunction because of their reduced capacity to use LDL receptor-mediated cholesterol uptake.…”

“…[23][24][25][26][27][28][29][30][31][32] Some of this concern was based on studies in isolated patients with abetalipoproteinemia and homozygous hypobetaliproteinemia showing mildly raised ACTH levels, normal cortisol levels, and a blunted response to prolonged ACTH stimulation. 33,34 Further studies of abetalipoproteinemic patients have not always confirmed these early observations, although the endocrine evaluations undertaken have varied substantially.…”

“…Although some studies have reported minor reductions of serum testosterone in statin-treated patients, the vast majority of studies showed no change in testosterone, gonadotropins, or semen quality. 24,27,29,30,[37][38][39][40]45,[52][53][54] Studies that included female patients found no change in ovarian steroidogenesis. 26,38,40,54 Our study confirms these findings and extends them to patients with very low levels of LDL-C.…”

Testicular Function in Hypercholesterolemic Male Patients During Prolonged Simvastatin Treatment

“…Some authors found a trend toward reduced basal plasma testosterone levels in lovastatin and pravastatin treated patients (To be rt et al 1982;Farnsworth et al 1987). Other studies have shown no adverse effects of lovastatin or simvastatin on testicular function (Mastroberardino et al 1989;Balestrieri et al 1990).…”

“…In animal models testicular damage occurred with elevated doses of simvastatin (Gerson, MacDonald, Alberts, Kornbrust, Mazjka, Stubbs and Bokelman 1989). In humans, earlier studies were carried out on patients treated with lovastatin (Tobert et al 1982;Farnsworth et al 1987;Mastroberardino et al 1989). Some authors found a trend toward reduced basal plasma testosterone levels in lovastatin and pravastatin treated patients (To be rt et al 1982;Farnsworth et al 1987).…”