The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Physiologic Testosterone Levels in Normal Men Suppress High-Density Lipoprotein Cholesterol Levels

Carrie J. Bagatell, MD; Robert H. Knopp, MD; Wylie W. Vale, PhD; Jean E. Rivier, PhD; and William J. Bremner, MD, PhD
[+] Article, Author, and Disclosure Information

Grant Support: By National Institutes of Health (NIH) grants P50-HD12629, HD00890-01, K0800890-01, and HD13527; the Clinical Research Center of the University of Washington, supported by NIH grant RR-37; the Clinical Nutrition Research Unit, supported by NIH grant DK35816; the Contraceptive Research and Development Agency, and the Department of Veterans Affairs.

Requests for Reprints: Carrie J. Bagatell, MD, Endocrinology (111), Department of Veterans Affairs Medical Center, 1660 South Columbian Way, Seattle, WA 98108.

Current Author Addresses: Drs. Bagatell and Bremner: Endocrinology (111), Department of Veterans Affairs Medical Center, 1660 South Columbian Way, Seattle, WA 98108.

Dr. Knopp: NW Lipid Research Center, 326 Ninth Avenue, Seattle, WA 98104.

Drs. Rivier and Vale: The Salk Institute, 10010 North Torrey Pines Road, La Jolla, CA 92037.

From the Department of Veterans Affairs Medical Center, Seattle, Washington; the University of Washington, Seattle, Washington; the Northwest Lipid Research Center, Seattle, Washington; and the Salk Institute, La Jolla, California. For current author addresses, see end of text.

Ann Intern Med. 1992;116(12_Part_1):967-973. doi:10.7326/0003-4819-116-12-967
Text Size: A A A

Objective: To investigate the role of physiologic levels of testosterone in the control of lipoproteins in healthy men.

Design: A double-blind, randomized study.

Setting: A university community.

Participants: Fifteen healthy men, ages 20 to 36 years.

Intervention: We induced acute, reversible hypogonadism in five normal men by administering daily subcutaneous injections of the gonadotropin-releasing-hormone (GnRH) antagonist, Nal-Glu, for 6 weeks. Another group of five normal men received Nal-Glu plus weekly injections of testosterone enanthate, 100 mg/wk, thereby maintaining normal serum testosterone levels. Five additional men received placebo injections.

Measurements: Plasma lipids, including high-density lipoprotein (HDL) subfractions HDL2 and HDL3, apoprotein A1, and serum levels of gonadotropins, estradiol, and testosterone were measured before, during, and after treatment.

Results: At the end of the treatment period, HDL cholesterol levels in men receiving Nal-Glu increased by 26% (95% Cl, 18% to 34%; P < 0.05). Levels of HDL2, HDL3, and apoprotein A1 increased by 63% (Cl, 16% to 110%), 17% (Cl, 3% to 31%), and 17% (Cl, 5% to 29%), respectively (P < 0.05 for each parameter). Total cholesterol increased by 12% (Cl, 2% to 22%). Low-density lipoprotein (LDL) cholesterol and triglyceride concentrations did not change. No statistically significant changes occurred in any lipid measurement in men receiving Nal-Glu plus androgen replacement or placebo (P > 0.05).

Conclusions: Experimental hypogonadism induced by administration of a GnRH antagonist results in a statistically significant increase in HDL cholesterol, including HDL2 and HDL3. These effects are most likely due to decreased androgen levels because they are reversed by administration of antagonist together with testosterone. Our results imply that androgen levels in the normal adult male range have a suppressive effect on HDL cholesterol concentration and may contribute to the increased risk for coronary artery disease in men.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.