SummaryIn a 1-year longitudinal study of 19 adolescent boys, our major aim was to assess whether, and to what degree, testosterone, estradiol, Quetelet index, and their interactions related to concentrations of high and low density lipoprotein cholesterol (HDLC, LDLC). During the I-year followup, mean HDLC and estradiol levels fell and triglycerides, LDLC, Quetelet index, and testosterone levels rose. For large decreases in estradiol, increases in testosterone were associated with decreases in HDLC. These decreases in HDLC were moderated by small decreases in Quetelet index. For boys with small decreases in estradiol, as the changes in testosterone increased, the change in HDLC varied from an increase to a decrease, except in those boys who also had a small decrease in Quetelet index, for whom the change in HDLC was positive. The greatest increases in LDLC were observed in boys having the largest increase in Quetelet index and a small decrease in estradiol; however, as the decrease in estradiol became large, the positive association of Quetelet with LDLC was moderated or nullified. For boys having large decreases in estradiol, the LDLC/HDLC ratio changed from small increments to substantial decrements as testosterone increased. As the decreases in estradiol became smaller, increases in the change of testosterone moderated the decreases in the LDLC/HDLC ratio, and large increases in Quetelet index tended to diminish this moderation. As the change in testosterone increased, the change in triglyceride increased, unless the decrease in estradiol was small. The overall pattern of change of HDLC and LDLC during sexual maturation in boys can be associated with changes in testosterone, estradiol, and Quetelet index. Abbreviations E2, estradiol HDLC, high density lipoprotein cholesterol LDLC, low density lipoprotein cholesterol Q, Quetelet index T, testosterone TG, triglycerideThe decrement in HDLC during male adolescence has been postulated to result from increased T production (16, 18); however, there is a significant positive correlation between HDLC and T in adult men (13,15,25,30). In adults, pharmacologic doses of exogenous T lower HDLC (2, 11). The reasons for this dichotomy remain to be fully explicated but different interactions of T and E2 during adolescence and adulthood may, in part, account for the opposite correlations of HDLC and T (18). For example, at the highest endogenous E2 levels, endogenous T is inversely associated with HDLC in adolescent males (18) whereas lower E2 and T levels in sexually mature men could be associated positively with HDLC.Prepubescent boys have, if anything, higher HDLC than girls (3, 28). The within-adolescence decrement in HDLC leads to the well recognized HDLC differential in sexually mature adults where men have lower HDLC, higher LDLC, and higher levels of TG than premenopausal women (14, 21). The adult male-female differences in lipoproteins (lower HDLC, higher LDLC, and higher TG) probably account, in part, for male-premenopausal female differences in atherosclerosis (32,...