Kaya C, Pabuccu R, Cengiz S D, Dünder I
Ufuk University, Department of Obstetrics and Gynecology.
Exp Clin Endocrinol Diabetes. 2010 Mar;118(3):161-6. doi: 10.1055/s-0029-1220770. Epub 2010 Feb 9.
Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism, insulin resistance (IR), and chronic inflammation. Simvastatin improves endocrine/clinical aspects of PCOS and decreases systemic inflammation in PCOS. There have been no comparative studies carried out regarding the effects of different statin treatment in PCOS. We aimed to assess the effects of two different statin treatments on various metabolic, endocrine, oxidative and inflammatory factors in PCOS.
Prospective, randomized clinical trial
Sixty-four (64) women with PCOS were included in the study. Group 1 had (atorvastatin, 20lmg daily; n=32) or group 2 had (simvastatin, 20l mg daily n=32). The metabolic, endocrine, inflammatory and oxidative profiles were evaluated.
Group 1 resulted in a significant reduction in the HOMA index and fasting insulin (-26.9+/-9.6%, -26.2+/-10.8%, P<0.01, respectively).CRP levels decreased by 63.6+/-15.9% in group 1 (P<0.01), whereas in the group 2 it decreased by 34.6+/-10.7% (P<0.05). Serum levels of LH declined by 19.1+/-4.5% (P<0.05) in the group 1 and by 39.3+/-11.9% (P<0.01) in the group 2. FAI decreased by -20+/-9.9% in group 1 (P<0.05) and it decreased by -38.7+/-13.8% in the group 2 (P<0.01). MDA levels decreased by 32.6+/-9.6% in group 1 (P<0.05), whereas in the group 2 it decreased by 30.3+/-10.9% (P<0.01). HOMA index and fasting insulin showed a reduction but not reached statistically significance in the group 2 (8.3+/-1.9%, 3.0+/-0.8%, P>0.05, respectively).
Both the statins are effective in reducing inflammation, hyperandrogenemia, oxidative stress and metabolic parameters. While atorvastatin has more noticeable effects on fasting insulin and insulin sensitivity, simvastatin has a dominant effect on total T in PCOS women.
多囊卵巢综合征（PCOS）与高雄激素血症、胰岛素抵抗（IR）和慢性炎症相关。辛伐他汀可改善PCOS的内分泌/临床症状，并降低PCOS患者的全身炎症反应。目前尚未有关于不同他汀类药物治疗PCOS效果的比较研究。我们旨在评估两种不同他汀类药物治疗对PCOS患者各种代谢、内分泌、氧化和炎症因子的影响。
前瞻性、随机临床试验
64例PCOS女性纳入本研究。第1组服用（阿托伐他汀，每日20mg；n = 32），第2组服用（辛伐他汀，每日20mg；n = 32）。评估代谢、内分泌、炎症和氧化指标。
第1组的HOMA指数和空腹胰岛素水平显著降低（分别为-26.9±9.6%，-26.2±10.8%，P<0.01）。第1组CRP水平下降63.6±15.9%（P<0.01），而第2组下降34.6±10.7%（P<0.05）。第1组血清LH水平下降19.1±4.5%（P<0.05），第2组下降39.3±11.9%（P<0.01）。第1组游离雄激素指数（FAI）下降-20±9.9%（P<0.05），第2组下降-38.7±13.8%（P<0.01）。第1组丙二醛（MDA）水平下降32.6±9.6%（P<0.05），第2组下降30.3±10.9%（P<0.01）。第2组的HOMA指数和空腹胰岛素水平有所下降，但未达到统计学意义（分别为8.3±1.9%，3.0±0.8%，P>0.05）。
两种他汀类药物均能有效减轻炎症、高雄激素血症、氧化应激和代谢参数。阿托伐他汀对空腹胰岛素和胰岛素敏感性的影响更显著，而辛伐他汀对PCOS女性的总睾酮有显著作用。
