Association of serum cholesterol and cholesterol-lowering drug use with serum sex steroid hormones in men in NHANES III
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Low cholesterol levels and statin drugs may protect against prostate cancer with a worse prognosis. Their protective mechanism is unknown, but has been hypothesized to be related to cholesterol’s role as a sex steroid hormone precursor. We evaluated whether serum testosterone and estradiol differ by cholesterol or cholesterol-lowering drug use.
Materials and methods
Testosterone and estradiol were measured for 1,457 male participants in the Third National Health and Nutrition Examination Survey. We estimated multivariable-adjusted geometric mean hormone concentration by quintiles of cholesterol concentration and by cholesterol-lowering drugs use.
Across quintiles of cholesterol, testosterone level did not differ (mean, 95% confidence interval (CI); Q1: 5.25, 5.02–5.49, Q5: 5.05, 4.76–5.37 ng/ml; p-trend = 0.32), whereas estradiol levels were lower (Q1: 38.7, 36.9–40.5; Q5: 33.1, 31.8–34.5 pg/ml; p-trend < 0.0001). Neither testosterone (no: 5.12, 4.94–5.30, yes: 4.91, 4.33–5.57 ng/ml, p = 0.57) nor estradiol (no: 35.9, 34.8–37.1; yes: 33.9, 29.4–39.2 pg/ml; p = 0.39) differed by cholesterol-lowering drugs use.
Testosterone did not differ by cholesterol or cholesterol-lowering drug use. Estradiol was lower in men with higher cholesterol, but did not differ by cholesterol-lowering drug use. Our results suggest that the lower risk of advanced prostate cancer among statin users is not readily explained by a cholesterol-mediated effect of statins on sex hormone levels.
KeywordsProstatic neoplasms Hydroxymethylglutaryl-CoA reductases Cholesterol Cross-sectional studies Gonadal steroid hormones
This is the 9th paper from the Hormone Demonstration Program funded by the Maryland Cigarette Restitution Fund at Johns Hopkins. Dr. Mondul was supported by a National Research Service Award (T32 CA009314) from the National Cancer Institute, National Institutes of Health. Dr. Selvin was supported by a grant (K01 DK076595) from the National Institutes of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
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