Finasteride is commonly prescribed to treat benign prostate hyperplasia and male-pattern baldness in cis men and, more recently, trans individuals. However, the effect of finasteride on cardiovascular disease remains elusive. We evaluated the role of finasteride on atherosclerosis using low-density lipoprotein (LDL) receptor-deficient () mice. Next, we examined the relevance to humans by analyzing the data deposited between 2009 and 2016 in the National Health and Nutrition Examination Survey. We show that finasteride reduces total plasma cholesterol and delays the development of atherosclerosis in mice. Finasteride reduced monocytosis, monocyte recruitment to the lesion, macrophage lesion content, and necrotic core area, the latter of which is an indicator of plaque vulnerability in humans. RNA sequencing analysis revealed a downregulation of inflammatory pathways and an upregulation of bile acid metabolism, oxidative phosphorylation, and cholesterol pathways in the liver of mice taking finasteride. Men reporting the use of finasteride showed lower plasma levels of cholesterol and LDL-cholesterol than those not taking the drug. Our data unveil finasteride as a potential treatment to delay cardiovascular disease in people by improving the plasma lipid profile.

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非那雄胺可延缓小鼠动脉粥样硬化进展，并与降低男性血浆胆固醇有关

非那雄胺通常用于治疗顺式男性以及最近的跨性别者的良性前列腺增生和男性型秃发。然而，非那雄胺对心血管疾病的作用仍然难以捉摸。我们使用低密度脂蛋白（LDL）受体缺陷（）小鼠评估了非那雄胺对动脉粥样硬化的作用。接下来，我们通过分析 2009 年至 2016 年国家健康和营养检查调查中存入的数据来检验其与人类的相关性。我们发现非那雄胺可以降低小鼠血浆总胆固醇并延缓动脉粥样硬化的发展。非那雄胺减少单核细胞增多、单核细胞向病灶的募集、巨噬细胞病灶含量和坏死核心区域，后者是人类斑块脆弱性的指标。 RNA测序分析显示，服用非那雄胺的小鼠肝脏中炎症途径下调，胆汁酸代谢、氧化磷酸化和胆固醇途径上调。报告使用非那雄胺的男性血浆胆固醇和低密度脂蛋白胆固醇水平低于未服用该药物的男性。我们的数据揭示了非那雄胺是一种通过改善血浆脂质谱来延缓人类心血管疾病的潜在治疗方法。