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

Abstract

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

Aging Men and Lipids

“…After that, the plasma testosterone level falls again and at 6 months are similar to those of girls of the same age (Anawalt & Merriam, 2001;Sarkar, 2009;Schleich & Legros, 2004;Villareal et al, 2005). Boys have the lowest levels of plasma testosterone between the age of 6 months and 6 years (0.2 ng/mL; Bain, 2007).…”

Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy

“…2 Interventional studies have also shown that testosterone replacement in hypogonadal men results in a significant decrease in total cholesterol, LDL cholesterol and triglycerides while serum HDL levels show an insignificant decrease. 3,4 Some authors believe that this significant decline in 'bad' cholesterol provides a counterbalance to this insignificant decrease in 'good' cholesterol. 4 These beneficial effects of testosterone are thought to be mediated via its aromatization to estrogen.…”

“…3,4 Some authors believe that this significant decline in 'bad' cholesterol provides a counterbalance to this insignificant decrease in 'good' cholesterol. 4 These beneficial effects of testosterone are thought to be mediated via its aromatization to estrogen. Hence, it is important to differentiate administration of testosterone from administration of non-aromatizable anabolic agents that are known to decrease HDL and increase LDL Lipid profile in hypogonadal men with prostate cancer M Braga-Basaria et al levels.…”

“…2 These findings are also supported by interventional studies that show that testosterone replacement in hypogonadal men results in an improvement in lipid profiles, especially reductions in triglycerides and LDL levels. 3,4 Though the levels of HDL also decline, in the majority of the studies, this decline is insignificant.…”

Body composition, metabolic syndrome and testosterone in ageing men

“…51 There are insufficient data from randomized controlled trials to conclude whether the route of administration of testosterone is a significant determinant of the observed changes in lipid profiles. 83 Insulin resistance. An inverse association has been reported between endogenous testosterone levels and either hyperinsulinaemia 63 or an increased likelihood of developing type II diabetes mellitus.…”