Association of serum testosterone with lipid abnormalities in patients with angiographically proven coronary artery disease

CONTEXT: Low testosterone levels are associated with an atherogenic lipid profile and may contribute to the pathogenesis of atherosclerosis. AIMS: Our study aimed to investigate the relationship between serum total testosterone (TT) levels and lipid profile in angiographically confirmed coronary artery disease (CAD) in men. SETTINGS AND DESIGN: This is a case-control hospital-based study at Teaching Hospital, Karapitiya, Galle, Sri Lanka. MATERIALS AND METHODS: Two hundred and six men, 103 with angiographically proven CAD and 103 healthy men as a control group were studied. The serum levels of TT and lipids were assessed. STATISTICAL ANALYSIS: Data were analyzed using Minitab software (version 15 for Windows). RESULTS: The mean concentrations of lipid parameters of patients and controls were as follows: Serum total cholesterol (TCh), 5.9 ± 2.8 vs. 5.2 ± 1.6 mmol/l (P = 0.022), low-density lipoprotein cholesterol (LDL-Ch), 3.9 ± 1.2 vs. 3.1 ± 0.5 mmol/l (P = 0.001), high-density lipoprotein cholesterol (HDL-Ch), 1.1 ± 0.5 vs. 1.4 ± 0.6 mmol/l (P = 0.001), and TGs, 2.0 ± 1.0 vs. 1.5 ± 0.8 mmol/l (P = 0.001); lipid levels were significantly different between the two groups. The mean levels of TT in the patients and controls were 11.4 ± 2.7 vs. 18.1 ± 7.2 nmol/l (P = 0.001), significantly different. Among CAD patients, a significant positive association was found between testosterone and HDL-Ch (r = 0.623, P = 0.001), whereas a negative association was found with LDL-Ch (r = -0.579, P = 0.001). CONCLUSIONS: Low levels of TT in men with CAD that appear together with an atherogenic lipid milieu may be involved in the pathogenesis of CAD. The observed association between testosterone and HDL-Ch suggests a protective effect of the hormone.