Elevated Serum Lipids in Hypogonadal Men with and without Hyperprolactinemia

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Abstract
Study Objective: To determine whether men with hypogonadism are at risk for hyperlipidemia. Design: Case-control study. Setting: Neuroendocrine clinical center of a referral-based university medical center. Patients: Consecutive sample of 18 men with testosterone deficiency who had prolactin-secreting pituitary adenomas, 15 men with acquired secondary hypoganadism and normal prolactin levels, and 33 normal male controls. Measurements and Main Results: We found a significant elevation in fasting cholesterol (6.23 .+-. 0.28 mmol/L [mean .+-. SE] compared with 5.17 .+-. 0.13 mmol/L [241 .+-. 11 mg/dL compared with 200 .+-. 5 mg/dL], P < 0.01), low density lipoprotein (LDL) cholesterol (4.11 .+-. 0.23 mmol/L compared with 3.34 .+-. 0.13 mmol/L [159 .+-. 9 mg/dL compared with 129 .+-. 5 mg/dL], P < 0.05), and triglycerides (1.85 .+-. mmol/L compared with 1.11 .+-. 0.07 mmol/L [164 .+-. 23 mg/dL compared with 98 .+-. 6 mg/dL] P < 0.001) in men with hyperprolactinemia compared with controls. In the normoprolactinemic hypogonadal men, cholesterol (6.28 .+-. 0.34 mmol/L [243 .+-. 13 mg/dL], P < 0.01), LDL cholesterol (4.34 .+-. 0.34 mmol/L [168 .+-. 13 mg/dL], P < 0.01), and triglycerides (1.61 .+-. 0.18 mmol/L [143 .+-. 16 mg/dL], P < 0.05) were also significantly higher than in the controls, and were the same as in the hyperprolactinemic men. High density lipoprotein (HDL) cholesterol did not differ among the three groups. Conclusion: Hypogonadism in men, with or without hyperprolactinemia, may be associated with elevation of fasting serum cholesterol, LDL cholesterol, and triglycerides compared with normal men. These data suggest that serum lipid levels should be evaluated in hypogonadal men. The presence of lipid abnormalities may affect the decision to treat testosterone deficiency in these patients.