The effect of cholesterol-lowering drugs on hormone related diseases
European Society of Cardiology (ESC) recently published guidelines recommending a reduction of LDL cholesterol levels to lower than 55 mg/dl for patients at very high risk of a cardiovascular event. Keeping in mind that cholesterol is the basic substrate for the synthesis of vital steroid hormones such as estrogen or testosterone, vitamin D and bile acids, detrimental side effects can be expected. Results of studies analysing the relationship between statins and sex hormone levels and bone density are inconsistent.
The aims of the project are to analyse the sex-specific effect of cholesterol lowering drugs on the hormone and immune system and bone density and structure.
The project is an observational study including four visits in one year. Controls are after 3, 6 and 12 months after baseline. Patients with hyperlipidaemia and start or extension of cholesterol lowering therapy are enrolled and divided in 5 groups: low dose statin, high dose statin therapy, combination therapy of proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitor in addition to statin therapy, PCSK-9-monotherapy and the control group – receiving only conservative treatment. Exclusion criteria are severe liver diseases, pregnancy, treated osteoporosis, malignant disorders, hepatitis B and C and HIV. During each visit blood analysis including cholesterol status, steroid hormones, immunological parameters, bile acid and bone formation and resorption markers is done.
To measure bone density and skeletal microarchitecture Dual Energy X-Ray Absorptiometry (DXA), high resolution quantitative computed tomography and ultrasound will be used at baseline and third and fourth study day.
Methods and Skills:
Posch A, Hofer-Zeni S, Klieser E, Primavesi F, Naderlinger E, Brandstetter A, Filipits A, Urbas R, Swiercynski S, Jäger T, Winkelmann P, Kiesslich T, Lu L, Neureiter D, Stättner S, Holzmann K: Hot spot TERT promoter mutations are rare in sporadic pancreatic neuroendocrine neoplasms and associated with telomere length and epigenetic expression patterns. Cancers (Basel) 12: 1625, 2020