The effect of atorvastatin in patients with polycystic ovary syndrome

A randomized double-blind placebo-controlled study

Thozhukat Sathyapalan, Eric S. Kilpatrick, Anne Marie Coady, Stephen Atkin

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Context: Polycystic ovary syndrome (PCOS) is associated with increased risk of cardiovascular morbidity, whereas statins are proven to reduce cardiovascular mortality and morbidity through lipid lowering and perhaps through their pleiotropic effects. Statins can also reduce testosterone in vitro by inhibiting ovarian theca-interstitial cell proliferation and steroidogenesis and reducing inflammation in vivo. Objective: Our objective was to assess the effect of atorvastatin on inflammatory markers, insulin resistance, and biochemical hyperandrogenemia in patients with PCOS. Design and Setting: We conducted a randomized, double-blind, placebo-controlled study at a tertiary care setting in United Kingdom. Patients: Patients included 40 medication-naive patients with PCOS and biochemical hyperandrogenemia. Methods: Patients were randomized to either atorvastatin 20 mg daily or placebo. Main Outcome Measures: The primary endpoint of the study was a change in the inflammatory marker high-sensitivity C-reactive protein. The secondary endpoints were a change in insulin resistance and total testosterone. Results: After 12 wk atorvastatin, there was a significant reduction (mean ± SEM) in total cholesterol (4.6 ± 0.2 vs. 3.4 ± 0.2 mmol/liter, P < 0.01), low-density lipoprotein cholesterol (2.9 ± 0.2 vs. 1.8 ± 0.2 mmol/liter, P < 0.01), triglycerides (1.34 ± 0.08 vs. 1.08 ± 0.13 mmol/liter, P < 0.01), high-sensitivity C-reactive protein (4.9 ± 1.4 vs. 3.4 ± 1.1 mg/liter, P < 0.04), free androgen index (13.4 ± 0.6 vs. 8.7 ± 0.4, P < 0.01), testosterone (4.1 ± 0.2 vs. 2.9 ± 0.1 nmol/liter, P < 0.01) and insulin resistance as measured by homeostasis model assessment for insulin resistance (HOMA-IR) (3.3 ± 0.4 vs. 2.7 ± 0.4). There was a significant increase in SHBG (31.1 ± 1.0 vs. 35.3 ± 1.2 nmol/liter, P < 0.01). There was a positive correlation between the reduction in HOMA-IR in the atorvastatin group with the reduction in triglycerides and the reduction of free androgen index. There was a significant deterioration of HOMA-IR in the placebo group (3.0 ± 0.4 vs. 3.8 ± 0.5). Conclusions: This study suggests that atorvastatin is effective in reducing inflammation, biochemical hyperandrogenemia, and metabolic parameters in patients with PCOS after a 12-wk period.

Original languageEnglish
Pages (from-to)103-108
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number1
DOIs
Publication statusPublished - Jan 2009
Externally publishedYes

Fingerprint

Polycystic Ovary Syndrome
Insulin Resistance
Placebos
Insulin
Theca Cells
Testosterone
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Homeostasis
C-Reactive Protein
Androgens
Triglycerides
Inflammation
Morbidity
Cell proliferation
Tertiary Healthcare
LDL Cholesterol
Deterioration
Atorvastatin Calcium
Cholesterol
Cell Proliferation

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

The effect of atorvastatin in patients with polycystic ovary syndrome : A randomized double-blind placebo-controlled study. / Sathyapalan, Thozhukat; Kilpatrick, Eric S.; Coady, Anne Marie; Atkin, Stephen.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 1, 01.2009, p. 103-108.

Research output: Contribution to journalArticle

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