Statin is a reasonable treatment option for patients with Polycystic Ovary Syndrome: a meta-analysis of randomized controlled trials.

OBJECTIVES

To date no consensus has been reached on whether to administer statin to patients with Polycystic Ovary Syndrome (PCOS) routinely. Therefore, we conduct a meta-analysis to synthesize the literatures regarding therapeutic effects of statins on PCOS.

METHODS

A comprehensive literature search was performed using terms such as polycystic ovary syndrome, ovary polycystic disease, PCOS, hyperandrogaenemia; simvastatin, atorvastatin, lipidemic-modulating drugs, lipid lowering drugs, and testosterone; randomized controlled trials in the following bibliographic databases: Medline, Embase, Cochrane Controlled Trials Register. Identified reference lists were checked manually.

RESULTS

In total, 4 RCTs were included. 3 of 4 studies were double-blinded while none reported whether of the data was analyzed using intention-to-treat analysis. Serum total testosterone and lipid profiles were included as investigation outcomes. Differences in reducing serum total testosterone were observed when comparing statin with placebo (Std MD= - 3.03, 95%CI - 5.85 ~ - 0.22, P=0.03) or statin + metformin with metformin (Std MD=- 1.07, 95%CI: - 2.06~ - 0.07, P=0.04). Heterogeneities were detected in both comparisons (I2=96% and 88% respectively). Meanwhile, statin was more effective than placebo in reducing LDL (WMD=- 0.87, 95%CI - 1.18~ - 0.55, P<0.0001), TC (WMD=- 1.23 95%CI - 1.35~ - 1.11, P<0.00001), TG (WMD= - 0.50, 95%CI - 0.73~ - 0.27, P<0.00001); and statin + metformin was more effective than metformin in lowering LDL (WMD= - 0.84, 95%CI: - 1.33 ~ - 0.354, P=0.0009), TC (WMD= - 1.28, 95%CI: - 1.47 ~ - 1.10, P<0.00001), and TG (WMD= - 0.27, 95%CI: - 0.36~ - 0.19, P<0.00001). Heterogeneities were detected during the meta-analysis.

CONCLUSIONS

Statins can reduce the concentration of total testosterone, TC, TG and LDL. However, it cannot be concluded that statins have long-term benefit. A large-scale, randomized controlled study is needed to ascertain this uncertainty.