ECE2023 Poster Presentations Adrenal and Cardiovascular Endocrinology (72 abstracts)
Atorvastatin use is associated with decreased testosterone levels in type 2 diabetes men
Ameni Terzi 1 , Elyes Kamoun 1 , Ibtissem Oueslati 1 , Hammami Bassem 2 , Nadia Khessairi 1 , Meriem Yazidi 1 , Fatma Chaker 1 , Feki Moncef 2 & Melika Chihaoui 1
1Rabta, Endocrinologie, Tunisia; 2Rabta, Biochemistry, Tunisia
Introduction: Statins are used in the management of hypercholesterolemia and the prevention of cardiovascular diseases. However, by reducing cholesterol biosynthesis, steroidogenesis and particularly testosterone synthesis may be affected. The aim of our study was to assess the effect of high doses of statin therapy on testosterone levels in type 2 diabetes male patients.
Methods: This was a single-center, prospective study, during the period march 2021 - July 2022, including 60 men with type 2 diabetes mellitus, aged between 40 and 65 years, statin-free, and in whom the indication of a treatment with high dose of statin was indicated. The patients had two visits, before and six months after the daily intake of 40mg of atorvastatin. During each visit, they underwent a clinical examination including the Androgen Deficiency in the Aging Male (ADAM) questionnaire and a fasting blood sample was collected for biological and hormonal measurements including total testosterone, sex hormone binding globulin, and gonadotrophins.
Results: The median age was 58 years (IQR:52-62). The median duration of diabetes was 81 months (IQR: 26-132). The prevalence of a positive ADAM questionnaire increased from 73% to 85% after statin use (P<10-3). Its median score raised from 4 (IQR: 2-6.75) to 6 (IQR: 3-8), P<10-3. We noted a significant increase in the prevalence of a decreased libido from 22% to 47% and erectile dysfunction from 70% to 75% and a significant decrease in nocturnal erections and the frequency of sexual intercourses. Twenty-two patients developed gynecomastia. The median of total and calculated bioavailable and free testosterone significantly decreased from 15.1, 6.3, and 0.3 to 12.7, 5.7, and 0.2 respectively, with no change in FSH and LH levels. Three patients (5%) developed hypogonadism.
Conclusion: Long-term high dose statin therapy induced clinical symptoms of hypogonadism and a reduction in testosterone levels.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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