Effects of gonadotropin and testosterone treatments on Lipoprotein(a), high density lipoprotein particles, and other lipoprotein levels in male hypogonadism.

Abstract

It is known that lipoprotein(a) [Lp(a) is an independent risk factor for developing atherosclerosis, whereas the LpA-I particle of high density lipoprotein (HDL) is an antiatherogenic factor. The effects of androgen replacement therapy on lipid and lipoproteins have previously been reported in male hypogonadism. However, no study reported the effect of gonadotropin or testosterone treatment on Lp(a), LpA-I, or LpA-I;A-II levels in make hypogonadism. We, therefore, determined Lp(a), LpA-I, LpA-I:A-II, and other lipoprotein levels before and 3 months after treatment in 22 patients with idiopathic hypogonadotropic hypogonadism (IHH) and in 9 patients with Klinefelter's syndrome. All patients had been previously untreated for androgen deficiency. Plasma FSH, LH, PRL, testosterone (T), estradiol, and dehydroepiandrosterone sulfate levels were also determined before and 3 months after treatment. Patients with IHH were treated with hCG/human menopausal gonadotropin, whereas patients with Klinefelter's syndrome received T treatment. Three months after treatment, mean T levels role to low normal levels in both groups. Triglyceride, LpA-I:A-II, Lp(a), HDL cholesterol, HDL3 cholesterol, and apolipoprotein (apo) A-I concentrations did not change significantly after treatment, whereas total cholesterol, low density lipoprotein cholesterol, LpA-I, and HDL2 concentrations were significantly increased 3 months after treatment in both groups. The apo B concentration significantly increased in patients with klinefelter's syndrome, whereas no change was observed in the IHH group. Lp(a) concentrations were not related to all hormonal and clinical parameters in both groups. LpA-I concentrations were significantly and negatively correlated with free T (r = -0.80; P = 0.010) in patients with Klinefelter's syndrome and were not correlated with all hormonal and clinical parameters in the IHH group. The LpA-I:A-II concentration was only correlated with body mass index (r = -0.83; P = 0.005) in patients with Klinefelter's syndrome, whereas it was correlated negatively with dehydroepiandrosterone sulfate (r = -0.57; P = 0.005) in the IHH group.2 Overall, our study demonstrates that gonadotropin or T treatment has a complex effect on lipids and lipoproteins. This complexity will be resolved when sufficient large scale androgen treatment data are available for assessment of the long term outcome of androgen treatment. The increases in total cholesterol and low density lipoprotein cholesterol concentrations after treatments are the adverse effects of these treatments, whereas the increases in HDL2 and LpA-I concentrations and the lack of changes in Lp(a) are the beneficial effects. Gonadotropin or T treatment did not modify the Lp(a) concentration, indicating that it is not affected by the hormonal milieu in male hypogonadism. Our study also showed that LpA-I, but not LpA-I:A-II, particles could be modified by androgen replacement therapy.

Effects of sex hormones on the development of giant lysosomes in the proximal tubules of DBA/2Cr mouse kidney

“…The clinical effects of testosterone treatment on serum LDL cholesterol levels vary -reports have shown an increase (Ozata et al 1996;Jockenhovel et al 1999), no change (von Eckardstein et al 1997;Snyder et al 2001) or a decrease (Zgliczynski et al 1996).…”

Randomized placebo‐controlled trial of testosterone replacement in men with mild Leydig cell insufficiency following cytotoxic chemotherapy

“…Published data concerning the influence of testosterone on lipid metabolism are contradictory. Both increases and decreases in LDL cholesterol, HDL cholesterol and total cholesterol have been observed following testosterone replacement in hypogonadal men (Hromadova et al ., 1989; Oppenheim et al ., 1989; Bagatell et al ., 1992; Asscheman et al ., 1994; Ozata et al ., 1996; Zgliczynski et al ., 1996). We observed no significant change in total cholesterol, HDL cholesterol or triglycerides following testosterone replacement, but there was a small but significant reduction in LDL cholesterol, with average levels during the study being 7% lower than at baseline.…”

Testosterone and obesity

“…Reduced TGs, LDL‐C, total cholesterol and increased HDL has also been reported following TRT . Testosterone treatment of hypogonadal and normal men additionally lowers lipoprotein a [Lp (a)] which is an LDL‐like particle that possesses atherogenic and thrombotic properties and is known to be an independent risk factor for atherosclerosis . The majority of studies on the effect of testosterone on HDL‐C, however, have generated contradictory results with either a decrease or no change .…”