Abstract

Abstract Materials and methods The study enrolled 2 men aged 58 years (history of acute cerebral circulation disorder at 47 and 57 years) and 64 years (history of acute myocardial infarction at 62 years), who complained of shortness of breath, daytime sleepiness, decreased libido, weakened erections, increased blood pressure. Both patients had been taking atorvastatin 10 mg for more than three months. We used high-performance liquid chromatography (HPLC) to determine steroid hormones in saliva: Agilent 1200 chromatograph, AB Sciex 3200 MD mass spectrometer (Sciex, USA). Saliva was collected in a Salivette container. A significant decrease in pregnenolone levels of 440.0 pg/ml and 300 pg/ml, respectively, was detected in the saliva analyses). The norm for pregnenolone was 575-665 pg/ml. Conclusion Statins lead to decreased pregnenolone secretion, most likely due to inhibition of HMG-CoA reductase, a key enzyme that converts 3-hydroxy-3-methyl glutaryl-CoA to mevalonate, a cholesterol precursor. The decrease in cholesterol synthesis leads to a decrease in pregnenolone and a decrease in steroid hormone secretion, both in the adrenal glands and gonads, which clinically manifests as hypogonadism and adrenal fatigue. All patients taking statins should have their salivary steroid profile evaluated. If statins cannot be withdrawn, hormone replacement therapy with sex hormones is necessary. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

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