NDLI: The effect of atorvastatin in patients with polycystic ovary syndrome: a randomized double-blind placebo-controlled study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Atkin, Stephen L. Sathyapalan, Thozhukat Kilpatrick, Eric S. Coady, Anne-Marie
Description	Country affiliation: United kingdom Author Affiliation: Sathyapalan T ( Department of Diabetes and Endocrinology , University of Hull, Hull HU6 7RX, United Kingdom. tsathyapal@rediffmail.com)
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.
ISSN	0021972X
e-ISSN	19457197
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	1
Volume Number	94
Language	English
Publisher	Oxford University Press
Publisher Date	2009-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Heptanoic Acids Therapeutic Use Hydroxymethylglutaryl-coa Reductase Inhibitors Polycystic Ovary Syndrome Drug Therapy Pyrroles Atorvastatin Calcium C-reactive Protein Cholesterol, Ldl Blood Double-blind Method Insulin Resistance Testosterone Randomized Controlled Trial Research Support, Non-u.s. Gov't Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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