Impact of Low LDL-C on Steroidogenesis in Diabetic Patients Receiving Statin Treatment

Pimjai Anthanont, MD¹,²,³ ORCID , Adisai Buakhamsri, MD⁴, Pichaya Tantiyavarong, MD, PhD⁴, Thipaporn Tharavanij, MD¹,²,³,⁵

Affiliation : ¹ Endocrinology and Metabolism Unit, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; ² Diabetes and Metabolic Syndrome Research Unit, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; ³ Thammasat University-Center of Excellence for Diabetic Foot Care, Thammasat University Hospital, Pathumthani, Thailand; ⁴ Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; ⁵ Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand

Objective: Steroidogenesis is associated with low-density lipoprotein (LDL) metabolism. The objective was to compare basal cortisol levels in statin-treated diabetic patients who had LDL-cholesterol (LDL-C) levels of less than 1.8 mmol/L (70 mg/dL) or 1.8 mmol/L or more.
Materials and Methods: Seventy-six statin-treated diabetic patients were divided into two groups of 38 patients each: low LDL-C (less than 1.8 mmol/L) and high LDL-C (1.8 mmol/L or more). Basal cortisol levels were measured, and adrenocorticotropic hormone (ACTH) stimulation tests were performed.
Results: The low LDL-C group had insignificantly higher basal cortisol levels. There were no significant differences in cortisol levels between the two groups at 20, 30, and 40 minutes during the 1-μg ACTH stimulation tests, nor among differing levels of statin intensity. There were also no significant differences in the proportion of patients with abnormal ACTH stimulation test results between low and high LDL-C groups.
Conclusion: The present data indicate that low LDL-C does not compromise steroidogenesis in diabetic patients receiving statin treatment. Aggressive LDL-C lowering in diabetic patients should be encouraged as indicated.

Received 28 November 2025 | Revised 21 January 2026 | Accepted 22 January 2026
DOI: 10.35755/jmedassocthai.2026.5.03902

Keywords : Cortisol; Statin; Low LDL-C; Diabetes; ACTH


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