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二甲双胍联合辛伐他汀治疗多囊卵巢综合征的前瞻性、随机、双盲、安慰剂对照研究。

Effects of metformin plus simvastatin on polycystic ovary syndrome: a prospective, randomized, double-blind, placebo-controlled study.

机构信息

Department of Obstetrics & Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Fertil Steril. 2010 Nov;94(6):2208-13. doi: 10.1016/j.fertnstert.2009.11.045. Epub 2010 Jan 15.

Abstract

OBJECTIVE

To evaluate the effect of a combination of simvastatin and metformin on biochemical parameters in women with polycystic ovary syndrome (PCOS).

DESIGN

A prospective, randomized, double-blind, placebo-controlled study.

SETTING

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.

摘要

目的

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。

设计

前瞻性、随机、双盲、安慰剂对照研究。

地点

大学医院。

患者

84 名 PCOS 女性患者随机分为两组。

干预

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。

主要观察指标

睾酮。

结果

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%。

结论

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。

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