When blood flow to the heart is blocked, it can cause chest pain (also called angina) or a heart attack (also called myocardial infarction). This narrowing blocks blood flow to and from your heart and other organs. Having high blood cholesterol can lead to a buildup called "plaque" on the walls of your arteries (a type of blood vessel). But you can take steps to lower your risk for high cholesterol by changing things you can control. Some people who have a family history of high cholesterol can also be at risk for high cholesterol. If you are an adult or child, a total cholesterol above 200 mg/dL may be considered high.1 This condition is also called hyperlipidemia. (A cholesterol check is also called a lipid panel or lipid profile.) While some LDL is necessary for normal body function, too much can harm blood vessels over time. LDL cholesterol carries fat molecules through the blood to tissues. Since heart health is a major concern for people considering TRT, understanding the research on this issue is important. By understanding these mechanisms, patients and doctors can better predict what might happen during therapy and why close monitoring is important. Regular blood testing helps track whether cholesterol changes are significant. The amount and length of testosterone exposure can change cholesterol effects. The way testosterone acts depends on many factors, such as age, dose, type of therapy, and individual metabolism. Triglycerides are the most common type of fat in the body. But there is another important fat in the blood called triglycerides. When people think about cholesterol, they often focus on LDL ("bad cholesterol") and HDL ("good cholesterol"). For example, some trials have found reduced HDL without any clear rise in cardiovascular events. For instance, one study has found that men with cardiovascular disease who have high testosterone levels also have high HDL cholesterol levels. One study from 2021 showed that low testosterone levels can raise cardiovascular risk, and testosterone replacement therapy, which supplements those levels, can decrease the risk of cardiovascular disease. Some studies suggest that testosterone therapy could have a positive effect on cholesterol levels, while other studies suggest no effect. Many studies have looked at how testosterone therapy affects cholesterol levels, but results are not always the same. When patients ask if testosterone therapy "increases LDL," they are really asking whether TRT makes the blood more likely to cause cardiovascular disease. To understand how testosterone therapy may change cholesterol levels, we first need to look at how cholesterol works in the body and what role testosterone plays in regulating it. Indeed, PCSK9 inhibitors display no detrimental effect on the testosterone level compared with statins in the previous study . Excessive testosterone has deleterious effects on the cardiovascular system. In the present study, we have demonstrated that testosterone deficiency decreased LDLR in hepatocytes, while its mRNA level remains unchanged. Numerical data, displayed in Table 2, comparing cases and controls were analyzed by two-sample t-tests for independent samples assuming unequal variance. Categorical baseline data displayed in Table 1 were analyzed by χ2 -test. The serum levels of TT were measured using a commercial EIA kit (Pathozyme Testosterone; Omega Diagnostics Ltd, Omega House, Hillfoots Business Village, Alva FK12 5DQ, Scotland, UK.; Star Fax 1000), according to the manufacturer's instructions and with the lowest detection limit of 0.06 ng/ml and a coefficient of variation ≤10%. Separated sera were aliquoted and stored in a freezer at -70°C until analysis for testosterone. The case group (age ranged from 30 to 70 years) included 103 consecutive male patients with angiographically diagnosed CAD, awaiting coronary artery bypass graft. Age and existing health conditions strongly influence how testosterone affects cholesterol. Because high triglycerides are linked to heart disease, this may be a positive effect of testosterone. Some studies show lower triglyceride levels after treatment, especially in men who also lose weight or improve insulin sensitivity while on therapy. Some men on testosterone therapy see little to no change in LDL, while others may experience a small increase or decrease depending on the form of therapy used. One important point is that changes in cholesterol numbers do not automatically mean someone will develop heart disease. There are several ways by which testosterone may affect lipid metabolism and atherosclerosis. The traditional risk factors of CAD were more prevalent among the cases compared with the controls, and 95.1% of the CAD patients were on statin treatment. The observed association between testosterone and HDL-Ch suggests a protective effect of the hormone. Low levels of TT in men with CAD that appear together with an atherogenic lipid milieu may be involved in the pathogenesis of CAD. They also help raise HDL levels and lower levels of harmful blood fats called triglycerides. For many of the models, we found a statistically significant interaction between CVD and the hormone. An interaction is present if the impact of the hormone on HDL-C varies by the level of a third variable. For all models, we tested for possible two-way interactions between each hormone and each confounder. Multiple linear regression analysis was used to model HDL-C level as a function of hormone level and potential confounders.
