Rosuvastatin decreases testosterone levels but not sexual function in men with type 2 diabetes

Objective: Statins may decrease serum testosterone levels via decreasing cholesterol, a precursor to testosterone. This case series studied the effects of rosuvastatin on free testosterone levels and sexual function in men with type 2 diabetes. Methods: We enrolled 151 men with type 2 diabetes and hypercholesterolemia. Biochemical assessments included serum total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein, triglyceride, prolactin, thyroid-stimulating hormone, luteinizing hormone, follicle stimulating hormone, total testosterone and serum sex hormone binding globulin (SHBG). All parameters were measured before statin treatment, after 6 months of statin treatment, and 6 months after discontinuing statin treatment. The Sexual Health Inventory for Men (SHIM) was also administered at these times. Results: Serum TC and LDL levels were high before statin therapy, decreased after six months of statin therapy, and increased significantly six months after discontinuing statin t(h)erapy (198.1 +/- 28.1 mg/dl vs. 147.1 +/- 22.8 mg/dl vs. 205.2 +/- 25.6 mg/dl, p-value < 0.001; 121.3 +/- 20.6 mg/dl vs. 75.4 +/- 20.4 mg/dl vs. 124.9 +/- 20 mg/dl, p-value < 0.001). However, serum free testosterone levels calculated from total testosterone and SHBG calculated by formula were higher before statin therapy, obviously decreased after six months of statin therapy, and subsequently increased six months after discontinuing statin therapy (22.4 +/- 3.1 ng/ml vs. 20.9 +/- 2.8 ng/ml vs. 22.6 +/- 2.6 ng/ml p value = 0.006). SHIM scores did not obviously differ among the three stages (16.3 +/- 4.8 vs. 16.0 +/- 4.9 vs. 16.3 +/- 5.0 p = 0.944). After adjustment for age, serum free testosterone levels correlated with SHIM scores and LDL (r = 0.39, p = < 0.001; r = 0.26, p = 0.02, respectively). SHIM scores did not correlate with TC or LDL. Conclusions: Rosuvastatin reduces free testosterone levels but does not influence sexual function in men with type 2 diabetes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.