Endocrine Abstracts

JOINT241

Introduction: Recommended cholesterol levels in cardiovascular prevention are continuously being lowered by clinical guidelines. Cholesterol is an essential substrate for the synthesis of steroid hormones. The aim of the study was to explore the adrenal glands’ ability to adapt to cholesterol deficiency as a substrate.

Methods: Thirty-six male patients on high-intensity hypolipidemic therapy with LDL-C levels of 0.5±0.3 mmol/l, documented for at least one year, were selected. Exclusion criterion was corticosteroid therapy, including local application, in the previous year and ageless than 18 years. The Synacthen (1-24 ACTH) test (10 μg) was performed, and 17 steroid hormones were measured at baseline and following stimulation at 0, 30, and 60 minutes. Additionally, baseline levels of ACTH, TSH, fT4, insulin, C-peptide, fasting blood glucose, and glycated hemoglobin were determined. All steroid measurements at baseline and after stimulation were performed using Liquid Chromatography-Mass Spectrometry (LCMS). The data obtained were statistically processed.

Results: Results showed a correlation between steroid hormones (sex hormone-binding globulin, testosterone, cortisol, 11-deoxycortisol, 11-deoxycorticosterone, 17α-hydroxyprogesterone) and LDL cholesterol levels, but no adrenocortical insufficiency was observed. These findings prove a correlation between LDL cholesterol and adrenal steroids, and highlight the safety of hypolipidemic therapy in clinical practice. We also, unexpectedely observed the association between various hormones (androstenedione, dehydroepiandrosterone, cortisol, cortisone, 11-deoxycorticosterone, 17α-hydroxyprogesterone, dihydrotestosterone) and HDL cholesterol levels.

Conclusion: The adrenal glands are capable of full adaptation to a profound cholesterol deficiency using it as a substrate for steroid hormone synthesis. Long-term hypolipidemic therapy does not induce adrenocortical insufficiency.

KeywordsCholesterol, Synacthen test, adrenal glands, adrenocortical insufficiency