Sex hormones
The effect of sex hormones on serum lipoproteins is best
illustrated by the pronounced differences in lipid and lipoprotein profiles
between adult men and pre-menopausal women. Men present with higher total serum
and LDL cholesterol, higher serum TAG, and lower HDL cholesterol concentrations
than premeno-pausal women. This difference in lipid profiles confers protection
against CHD on premenopausal women so that their CHD risk lags some 10 years
behind that of men of the same age. This applies until estrogen failure at the
menopause, when CHD risk in women overtakes that of men. Estrogen was the first
com-pound shown to stimulate LDL receptor activity in cell culture, an effect
that not only accounts for lower LDL levels in women but also the sharp
increase in LDL cholesterol after the menopause, to levels above those of men.
Estrogens also stimulate the pro-duction of TAG and VLDL, but any adverse
effects must be outweighed by the efficiency of TAG removal mechanisms that
maintain lower serum TAG levels in women than in men until the menopause. In
addition to these effects, estrogen selectively inhibits the activ-ity of HL,
which contributes to the HDLs in women. In direct contrast, the androgenic male
hormone tes-tosterone suppresses LDL receptor activity, raising LDL
cholesterol. It is also a powerful stimulant of HL activity, and is responsible
for lowering HDL choles-terol in men, most notably in male body builders on
anabolic steroids, in whom serum HDL can be almost absent.
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