Steroids and lipid metabolism: mechanism of action

The effects of steroids on hepatic metabolism depend on the preexisting metabolic status of the individual and the structure, dosage, and, to a certain extent, the route of administration of the steroid compound. Oral administration of synthetic estrogen causes an increase in hepatic production of very-low-density lipoprotein (causing in turn an increase in triglyceride levels), an increase in coagulation factors, and an increase in high-density-lipoprotein cholesterol, which is related to a decrease in hepatic lipase activity. Parenteral administration of estrogen does not appear to cause any such modification. The effects of progestogen on hepatic metabolism are dependent on the androgenic activity of the specific progestogen administered. A progestogen with greater androgenic activity causes a decrease in high-density-lipoprotein cholesterol, which is related to an increase in hepatic lipase activity. This article reviews the effects of steroids (both estrogens and progestogens) on the mechanisms of action in lipid metabolism.