Department of Obstetrics & Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
Fertil Steril. 2010 Nov;94(6):2208-13. doi: 10.1016/j.fertnstert.2009.11.045. Epub 2010 Jan 15.
To evaluate the effect of a combination of simvastatin and metformin on biochemical parameters in women with polycystic ovary syndrome (PCOS).
A prospective, randomized, double-blind, placebo-controlled study.
University hospital.
PATIENT(S): Eighty-four women with PCOS randomly divided to two study groups.
INTERVENTION(S): Patients were randomly assigned to receive metformin (500 mg three times a day) plus simvastatin (20 mg/day, n=42; group 1) or metformin (500 mg three times a day) plus placebo (once a day, n=42; group 2) for 12 weeks. Blood samples were obtained before and after treatment.
MAIN OUTCOME MEASURE(S): Testosterone.
RESULT(S): After 12 weeks of treatment, serum T levels decreased by 25.5% in group 1 and by 16.8% in group 2. There was a greater decrease of LH (45.5% vs. 6.7%) and a greater decline of the LH/FSH ratio (38.3% decreased vs. 4.4% increased) in the first group. In group 1 there was a greater decrease of total cholesterol (29.5% vs. 4.2%), low-density lipoprotein (LDL; 18.5% vs. 1.5%), and triglycerides (32% vs. 5.3%). High-density lipoprotein (HDL) increased in the first group by 14%, whereas it decreased by 1% in the second group.
CONCLUSION(S): This report has demonstrated that the combination of metformin and simvastatin could lead to a better reduction of T and LH levels and thus reversing the LH:FSH ratio, lipid profile, and insulin resistance in patients with PCOS and may be an appropriate management option for patients with PCOS.
评估辛伐他汀和二甲双胍联合治疗多囊卵巢综合征(PCOS)女性生化参数的效果。
前瞻性、随机、双盲、安慰剂对照研究。
大学医院。
84 名 PCOS 女性患者随机分为两组。
患者被随机分配接受二甲双胍(500mg,每日三次)加辛伐他汀(20mg/天,n=42;第 1 组)或二甲双胍(500mg,每日三次)加安慰剂(每日一次,n=42;第 2 组)治疗 12 周。治疗前后采集血样。
睾酮。
治疗 12 周后,第 1 组血清 T 水平降低 25.5%,第 2 组降低 16.8%。第 1 组 LH 降低更明显(45.5% vs. 6.7%),LH/FSH 比值下降更明显(38.3%下降 vs. 4.4%升高)。第 1 组总胆固醇(29.5% vs. 4.2%)、低密度脂蛋白(LDL;18.5% vs. 1.5%)和甘油三酯(32% vs. 5.3%)降低更明显。第 1 组高密度脂蛋白(HDL)升高 14%,而第 2 组降低 1%。
本报告表明,二甲双胍和辛伐他汀联合治疗可导致 T 和 LH 水平更好地降低,从而逆转 PCOS 患者的 LH/FSH 比值、血脂谱和胰岛素抵抗,可能是 PCOS 患者的一种合适的治疗选择。