Statin therapy may decrease the levels of serum
steroid hormones, including
testosterone and
cortisol, accompanied by lowering
low-density lipoprotein cholesterol (
LDL-C) levels, which remains to be investigated. The aim of this study is to examine the association between
steroid hormones and
lipids under
statin therapy and its clinical impact on the cardiovascular event risk from a viewpoint of
steroid hormone metabolism. Using a population dataset extracted from the standard versus intEnsive
statin therapy for hyper-cholesteroleMic Patients with
diAbetic retinopaTHY (EMPATHY) study, we analyzed the correlation between
steroid hormones and
lipid profiles at registration and 1 year after registration, comparing between male patients with or without cardiovascular events (CV events) within 4 years (CV events + ; n = 100, and CV events - ; n = 100, respectively) after prognostic score matching. The risk for CV events was evaluated using conditional logistic regression analysis.
Testosterone levels were lower in the CV events + group than in the CV events - group at registration (5.2 ± 2.2 vs. 7.6 ± 4.1 ng/mL, p < 0.001).
Testosterone levels were lowered to 5.1 ng/mL on average in proportion with
LDL-C lowering, and Δtestosterone was correlated with ΔLDL-C during 1 year after registration.
Cortisol levels were not correlated with
LDL-C levels. In addition,
testosterone levels at 1 year after registration were not associated with cardiovascular event risk. In male hypercholesterolemic patients with
diabetic retinopathy,
testosterone levels were positively correlated with
LDL-C levels, which were mildly lowered in proportion with
LDL-C lowering under mild
statin therapy. This decrease in
testosterone levels under
statin therapy was not related to the increase in cardiovascular event risk.Clinical trial registration: UMIN 000003486. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000004199.