Do Statins Affect and Rogen Levels in Men? Results from the BOSTON AREA COMMUNITY HEALTH (BACH) Survey

Purpose In 2005, statins were among the most commonly-used prescription medications in the United States. Some data suggest statins may affect cancer risk and/or disease severity. Because cholesterol is a required intermediate in sex steroid synthesis, it is possible that statins influence prostate cancer risk through effects on steroid hormone metabolism. We investigated whether levels of circulating androgens varied by statin exposure in a population-based epidemiologic study, the Boston Area Community Health (BACH) Survey. Methods We measured serum total testosterone (TT), free testosterone (FT), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS) and luteinizing hormone (LH). Statin exposure was collected by participant self-report and/or interviewer-recorded information. Multivariate linear models were constructed to account for potential confounding of any statin use-androgen relationship. Results Among 1824 men, the prevalence of statin use was 12.6% (95% confidence interval (CI): 10.5% to 15.0%). On average, statin users were older, had larger BMI, more chronic illnesses, and used more medications. We found no relationship between statin use and FT, DHEAS, or LH. A significant association between statin use and serum TT concentrations was initially observed but was not robust to covariate control in a multivariate model that included age, BMI, time since wake, and history of cardiovascular disease and diabetes: (-5.3%, 95% CI:-13.0%, 3.0%). For SHBG, a significant decrease in levels among statin users was observed in multivariate models adjusted similarly: (-10.6%, 95% CI: -11.7%, -1.6%). Conclusion In this sample, it is unlikely that statins affect circulating androgens and prostate cancer risk through a hormonal mechanism.