title: The effect of ezetimibe-statin combination on steroid hormone production in men with coronary artery disease and low cholesterol levels.
abstract: BACKGROUND
  Aggressive statin treatment was found to slightly reduce testosterone production. The aim of this study was to compare the effects of ezetimibe-statin combination and high-dose statin therapy on testicular and adrenal cortex function in men with LDL cholesterol levels below 70 mg/dL.
  
  
  METHODS
  The study included 26 adult men with coronary artery disease. Twelve of these patients did not tolerate high-dose statin therapy and were treated with lower doses of a statin plus ezetimibe. Fourteen patients tolerating high-dose simvastatin or rosuvastatin treatment continued high-dose statin therapy throughout the study period. Plasma lipids, glucose homeostasis markers and plasma levels of testosterone, cortisol, dehydroepiandrosterone sulphate, sex hormone-binding globulin, gonadotropins and ACTH, as well as urine free cortisol were assessed at baseline and after 16 weeks of treatment.
  
  
  RESULTS
  Replacing high-dose statin therapy with ezetimibe/statin combination therapy reduced plasma levels of LH by 32% (p=0.043), as well as increased plasma levels of testosterone by 20% (p=0.038). Ezetimibe/statin combination did not induce any significant changes in plasma levels or urine excretion of the remaining hormones. At the end of the study, plasma LH levels were higher, while plasma testosterone levels were lower in patients receiving the combination therapy than in those treated only with high-dose statin.
  
  
  CONCLUSIONS
  Our results indicate that ezetimibe combined with moderate statin dose exerts a less pronounced effect on testicular function in comparison with high-dose statin therapy.
authors.affiliation: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland. Electronic address: r.krysiak@interia.pl.
authors.forename: Robert
authors.initials: R
authors.lastname: Krysiak
authors.affiliation: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland; Department of Endocrinology, Provincial Hospital, Opole, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kowalska
authors.affiliation: Invasive Cardiology, Electrotherapy and Angiology Centre, Oświęcim, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Żmuda
authors.affiliation: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
authors.forename: Bogusław
authors.initials: B
authors.lastname: Okopień
mesh_terms: D000302:Adrenal Cortex / Q000187:drug effects / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects; D002784:Cholesterol / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004359:Drug Therapy, Combination / Q000009:adverse effects; D000069438:Ezetimibe / Q000009:adverse effects*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D000068718:Rosuvastatin Calcium / Q000009:adverse effects*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D019821:Simvastatin / Q000009:adverse effects*; D013256:Steroids / Q000096:biosynthesis* / Q000097:blood*; D013737:Testis / Q000187:drug effects / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D012738:Sex Hormone-Binding Globulin; D013256:Steroids; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D000068718:Rosuvastatin Calcium; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002784:Cholesterol; D019821:Simvastatin; D000069438:Ezetimibe; D006854:Hydrocortisone
keywords: Adrenal cortex; Ezetimibe; Statins; Steroid hormones; Testis