Journal of Clinical Endocrinology & Metabolism, Vol 81, 3372-3378, Copyright © 1996 by Endocrine Society

ARTICLES

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

M Ozata, M Yildirimkaya, M Bulur, K Yilmaz, E Bolu, A Corakci and MA Gundogan
Department of Endocrinology and Metabolism, Gulhane School of Medicine, Etlik-Ankara, Turkey.

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.

This article has been cited by other articles:

				E. Nieschlag, H.M. Behre, P. Bouchard, J.J. Corrales, T.H. Jones, G.K. Stalla, S.M. Webb, and F.C.W. Wu Testosterone replacement therapy: current trends and future directions Hum. Reprod. Update, September 1, 2004; 10(5): 409 - 419. [Abstract] [Full Text] [PDF]

				K. L. Herbst, J. K. Amory, J. D. Brunzell, H. A. Chansky, and W. J. Bremner Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk Am J Physiol Endocrinol Metab, June 1, 2003; 284(6): E1112 - E1118. [Abstract] [Full Text] [PDF]

				F. C. W. Wu and A. von Eckardstein Androgens and Coronary Artery Disease Endocr. Rev., April 1, 2003; 24(2): 183 - 217. [Abstract] [Full Text] [PDF]

				A. M. Kenny, K. M. Prestwood, C. A. Gruman, G. Fabregas, B. Biskup, and G. Mansoor Effects of Transdermal Testosterone on Lipids and Vascular Reactivity in Older Men With Low Bioavailable Testosterone Levels J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2002; 57(7): M460 - 465. [Abstract] [Full Text]

				P. Kunelius, O. Lukkarinen, M. L. Hannuksela, O. Itkonen, and J. S. Tapanainen The Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1467 - 1472. [Abstract] [Full Text] [PDF]

				G. Ricci, G. Tamaro, R. Simeone, E. Giolo, G. Nucera, F. De Seta, and S. Guaschino Lipoprotein(a) changes during natural menstrual cycle and ovarian stimulation with recombinant and highly purified urinary FSH Hum. Reprod., March 1, 2001; 16(3): 449 - 456. [Abstract] [Full Text] [PDF]

				C. Hadigan, C. Corcoran, T. Stanley, S. Piecuch, A. Klibanski, and S. Grinspoon Fasting Hyperinsulinemia in Human Immunodeficiency Virus-Infected Men: Relationship to Body Composition, Gonadal Function, and Protease Inhibitor Use J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 35 - 41. [Abstract] [Full Text]

				D. Büchter, S. von Eckardstein, A. von Eckardstein, A. Kamischke, M. Simoni, H. M. Behre, and E. Nieschlag Clinical Trial of Transdermal Testosterone and Oral Levonorgestrel for Male Contraception J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1244 - 1249. [Abstract] [Full Text]

				A. von Eckardstein, S. Kliesch, E. Nieschlag, A. Chirazi, G. Assmann, and H. M. Behre Suppression of Endogenous Testosterone in Young Men Increases Serum Levels of High Density Lipoprotein Subclass Lipoprotein A-I and Lipoprotein(a) J. Clin. Endocrinol. Metab., October 1, 1997; 82(10): 3367 - 3372. [Abstract] [Full Text] [PDF]