High-Density Lipoprotein Function Is Reduced in Patients Affected by Genetic or Idiopathic Hypogonadism

Maria Pia Adorni, Francesca Zimetti, Biagio Cangiano, Valeria Vezzoli, Franco Bernini, Donatella Caruso, Alberto Corsini, Cesare R. Sirtori, Anna Cariboni, Marco Bonomi, Massimiliano Ruscica

Research output: Contribution to journalArticlepeer-review


Context Low testosterone levels are associated with an increased incidence of cardiovascular (CV) events, but the underlying biochemical mechanisms are not fully understood. The clinical condition of hypogonadism offers a unique model to unravel the possible role of lipoprotein-associated abnormalities in CV risk. In particular, the assessment of the functional capacities of high-density lipoproteins (HDLs) may provide insights besides traditional risk factors. Design To determine whether reduced testosterone levels correlate with lipoprotein function, HDL cholesterol (HDL-C) efflux capacity (CEC) and serum cholesterol loading capacity (CLC). Participants Genetic and idiopathic hypogonadal patients (n = 20) and control subjects (n = 17). Results Primary and secondary hypogonadal patients presented with lower HDL ATP-binding cassette transporter A1 (ABCA1)-, ATP-binding cassette transporter G1 (ABCG1)-, and aqueous diffusion-mediated CEC (-19.6%, -40.9%, and -12.9%, respectively), with a 16.2% decrement of total CEC. In the whole series, positive correlations between testosterone levels and both total HDL CEC (r 2 = 0.359, P = 0.0001) and ABCG1 HDL CEC (r 2 = 0.367, P = 0.0001) were observed. Conversely, serum CLC was markedly raised (+43%) in hypogonadals, increased, to a higher extent, in primary vs secondary hypogonadism (18.45 ± 2.78 vs 15.15 ± 2.10 μg cholesterol/mg protein) and inversely correlated with testosterone levels (r 2 = 0.270, P = 0.001). HDL-C concentrations did not correlate with either testosterone levels, HDL CEC (total, ABCG1, and ABCA1) or serum CLC. Conclusions In hypogonadal patients, proatherogenic lipoprotein-associated changes are associated with lower cholesterol efflux and increased influx, thus offering an explanation for a potentially increased CV risk.

Original languageEnglish
Pages (from-to)3097-3107
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Issue number8
Publication statusPublished - Jun 19 2019

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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