MP35-15: Do statins cause testosterone deficiency in men? Systematic review and meta analysis.

Felipe Glina, Leonardo Seligra Lopes*, Rodrigo Spinola e Silva, Eduardo Augusto Correa Barros, Santo André - SP, Brazil, Bruno Biselli, São Paulo, Brazil, Sidney Glina, Santo André - SP, Brazil

Introduction:

Introduction:  Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the precursor of the steroidogenesis pathway, the use of statin could cause a reduction in testosterone levels. Testosterone is essential in biological functions and its reduction can cause negative effects, such as symptoms of hypogonadism.

Objective:  Evaluate whether the continued use of statins causes testosterone deficiency in men.

Methods: Systematic Review with Meta-analysis, performed in Medline databases through Pubmed, Embase and Cochrane, until April 2021, PROSPERO CRD42021270424 protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement 2021 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Selected epidemiological studies (cross-sectional studies and ecological studies), with assessed outcome of total testosterone between groups. Bias analysis performed using the MOOSE questionnaire (meta-analysis of observational studies in epidemiology).

Results: A total of 833 articles were retrieved from MedLine (n = 717), from Embase (n = 1352) and from Cochrane (n = 143). Six articles were submitted to meta-analysis. The forrest plot evidenced a reduction in the mean testosterone in patients under continuous use of statins of 55.02 (95% CI=39.40-70.64, I²=91%, p<0.00001), demonstrating statistical significance.
A reduction in total testosterone was shown in all studies, with the exception of Mondul 2010, and in the cumulative analysis of the forrest plot in patients taking statins. However, this mean reduction was not enough to reach levels below normal, 300ng / dl.

Conclusions: Statins cause a decrease in total testosterone, not enough to cause a significant deficiency.

Source of Funding: No funding source was used by the authors.