The influence of steroid hormones on plasma lipids and lipoproteins was confirmed by many studies. On the other hand, the effect of plasma lipids on metabolism of steroid hormones has so far not been examined. The objective of this research project was to determine (1) the levels of cortisol, testosterone, estradiol, dehydroepiandrosterone (DHEA), its sulfate (DHEAS), 7-hydroxylated DHEA, and SHBG in men suffering from mixed hyperlipidemia (HPL) (n=23, age 46.1±7.9 years) in comparison with healthy male volunteers (n=17, age 45.1±15.6 years); (2) whether therapy with fenofibrate influences the levels of the above mentioned steroids and SHBG; (3) what are the correlations between lipids and steroids in healthy males and HPL patients before and after therapy. Compared to controls, untreated patients had significantly higher estradiol and free testosterone index (IFT) levels (p<0.0003 and p<0.02, respectively) and significantly lower SHBG (p<0.02). Due to fenofibrate therapy, a significant decrease of TC, TG, and DHEA levels occurred (mean decrease: 14 %, 52 % and 21 %, respectively). Triglycerides correlated negatively with testosterone and SHBG in healthy subjects. HDL-C
correlated positively and consequently, atherogenic index correlated negatively with 7-hydroxylated epimers of DHEAin treated patients. This is the first study dealing with the influence of fenofibrate administration on the steroid levels. Taking together, the most important is the finding of decrease DHEA levels after fenofibrate therapy. It could be explained, at least in part, by the effect of the fenofibrateon on the biosynthesis of DHEA and its regulation.
Dehydroepiandrosterone may influence thyroid function. Its metabolite, 7-oxo-dehydroepiandrosterone, a precursor of immunomodulatory 7-hydroxylated metabolites and thermogenic agent, belongs to candidates of steroid replacement therapy. The question was addressed whether its application does influence laboratory parameters of thyroid function. 7-Oxo-dehydroepiandrosterone in the form of emulgel, 25 mg/day, was applied transdermally to 21healthy men for 8 consecutive days. Morning blood was collected before the treatment (Day 0, Stage 1), during treatment (Day 5, Stage 2), on the first day after the last administration (Day 9, Stage 3), one week (Day 16, Stage 4), and 9 weeks (Day 72, Stage 5) after treatment termination. The levels of thyrotropin, free thyroxine and triiodothyronine, dehydroepiandrosterone, its sulfate and its 7-hydroxyepimers were measured. The changes were evaluated by analysis of variance and correlation analysis. During treatment a significant rise of 7β-hydroxy-dehydroepiandrosterone was
observed, which persisted 1 week after treatment termination. No changes were observed in dehydroepiandrosterone and its sulfate. Though a slight but significant rise of TSH and of both thyroid hormones occurred during treatment, its levels soon returned to the basal values. It was concluded that treatment of 7-oxo- dehydroepiandrosterone affects the
thyroid parameters only temporarily and that it provides a considerable persistent amount of 7β-hydroxy-dehydroepiandrosterone.