Mitotane-Induced Hyperlipidemia : A Retrospective Cohort Study

Abstract EN

Limited data are available about mitotane-nduced hyperlipidemia.

We retrospectively analyzed lipid data in 38 patients with adrenocortical carcinoma (ACC) who received mitotane therapy with emphasis on HDL cholesterol (HDL-c) and clinical predictors of lipid changes.

At baseline, the mean levels of HDL-c, LDL-c, and triglycerides were 53.3 mg/dL, 114.4 mg/dL, and 149 mg/dL, respectively.

HDL-c, LDL-c, and triglyceride concentrations significantly increased with mitotane therapy to a mean HDL peak (HDL-P) of 86.3 mg/dL (P<0.001), a mean LDL peak of 160.1 mg/dL (P<0.001), and a mean triglyceride peak (Tg-P) of 216.7 mg/dL (P=0.042).

HDL-P positively correlated with mitotane concentration (r=0.52,P<0.001), while LDL-P levels and Tg-P did not.

Gender, body mass index, cortisol overproduction, baseline levels of HDL-c, and triglyceride did not predict change in HDL-c.

Similar changes were noticed in subgroup analysis after excluding patients who were using lipid-lowering agents.

In conclusion, in ACC patients, mitotane caused significant increases in HDL-c that may counteract the deleterious atherosclerotic effects of LDL-c and Tg rise.

Understanding the mechanism of HDL change may lead to the discovery of novel HDL-c-elevating drugs.