title: Use of statins is associated with lower serum total and non-sex hormone-binding globulin-bound testosterone levels in male participants of the Rotterdam Study.
abstract: OBJECTIVE
  Statins, or HMG-CoA reductase inhibitors, decrease cholesterol production. Because cholesterol is a precursor of the testosterone biosynthesis pathway, there is some concern that statins might lower serum testosterone levels. The objective of the present study was to investigate the association between the use of statins and serum testosterone levels in men.
  
  
  METHODS
  Cross-sectional study within the prospective population-based Rotterdam Study.
  
  
  METHODS
  We included 4166 men with available data on total testosterone, non-sex hormone-binding globulin (SHBG)-bound testosterone, and medication use. Multivariable linear regression analysis was used to compare the differences in serum testosterone levels (nmol/l) between current, past, and never statin users. We considered dose and duration of use. Analyses were adjusted for age, BMI, cardiovascular disease, diabetes mellitus, hypertension, and estradiol levels.
  
  
  RESULTS
  We identified 577 current (mean age 64.1 years), 148 past (mean age 64.6 years), and 3441 never (mean age 64.6 years) statin users. Adjusted for all covariables, current statin use of 1-≤ 6 months or >6 months was significantly associated with lower total testosterone levels as compared to non-users (β -1.24, 95% CI -2.17, -0.31, and β -1.14, 95% CI -2.07, -0.20 respectively). Current use of 1-≤ 6 months was also associated with significantly lower non-SHBG-bound testosterone levels (β -0.42, 95% CI -0.82, -0.02). There was a trend toward lower testosterone levels at higher statin doses both for total (P(trend) 2.9 × 10(-5)) and non-SHBG-bound (P(trend) 2.0 × 10(-4)) testosterone. No association between past statin use and testosterone levels was found.
  
  
  CONCLUSIONS
  We showed that current use of statins was associated with significantly lower serum total and non-SHBG-bound testosterone levels. The clinical relevance of this association should be further investigated.
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: de Keyser
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Filipe Valerio
authors.initials: FV
authors.lastname: de Lima
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Frank H
authors.initials: FH
authors.lastname: de Jong
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Yolanda B
authors.initials: YB
authors.lastname: de Rijke
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: André G
authors.initials: AG
authors.lastname: Uitterlinden
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands.
authors.forename: Loes E
authors.initials: LE
authors.lastname: Visser
authors.affiliation: Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands Department of EpidemiologyErasmus Medical Center, PO Box 2040, 3000CA Rotterdam, The NetherlandsThe Health Care InspectorateThe Hague, The NetherlandsDepartments of Internal MedicineClinical ChemistryErasmus Medical Center, Rotterdam, The NetherlandsHospital PharmacyThe Hague Hospitals - HAGA, The Hague, The Netherlands b.stricker@erasmusmc.nl.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone