Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, MSC7004, Bethesda, MD, 20894, USA.
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Reprod Health. 2019 Sep 2;16(1):132. doi: 10.1186/s12978-019-0794-6.
Inflammation and elevated blood lipids are associated with infertility. Aspirin and statin therapy may improve infertility treatment outcomes among overweight and obese women with systemic inflammation, but little is known about the short-term effects of statins in this population. We conducted a pilot study of aspirin, pravastatin, or combined treatment among a group of overweight and obese, reproductive-aged women. Our goal was to characterize short-term changes in inflammatory and lipid biomarkers during and after treatment.
In this open-label trial, women aged 18-40 years with a body mass index ≥25 kg/m were randomized to receive either 162 mg aspirin, 40 mg pravastatin, or both. The study medication was taken daily for 2 weeks, and participants were then followed for a two-week washout period. Participants provided blood samples at baseline, after the intervention period, and after the washout period. The outcomes were changes in biomarkers of inflammation and lipids measured in blood components at each timepoint.
Nine, 8, and 8 women were randomized to the aspirin, pravastatin, and combined arms, respectively. Analyses were conducted among 8, 7, and 7 women in the aspirin, pravastatin, and combined arms for whom biomarker data was available at baseline. High-sensitivity C-reactive protein (hsCRP) levels were lower after treatment in all arms and continued to decrease after washout in the pravastatin and combined arms. Results were consistent between the whole sample and women with baseline hsCRP between 2 and 10 mg/L. Low-density lipoprotein (LDL) cholesterol was lower after treatment in the pravastatin and combined arms and rose slightly after washout.
Our results provide preliminary evidence that short-term aspirin and pravastatin therapy reduces hsCRP and LDL cholesterol among overweight and obese women of reproductive age, including those with low-grade inflammation. Because of these short-term effects, these drugs may improve infertility treatment outcomes in this population, which we will assess in a future randomized trial.
炎症和血液脂质升高与不孕有关。阿司匹林和他汀类药物治疗可能会改善超重和肥胖伴有全身炎症的女性的不孕治疗结局，但对于该人群中他汀类药物的短期疗效知之甚少。我们对一组超重和肥胖的育龄妇女进行了阿司匹林、普伐他汀或联合治疗的初步研究。我们的目标是描述治疗期间和治疗后炎症和脂质生物标志物的短期变化。
在这项开放标签试验中，年龄在 18-40 岁之间、体重指数≥25kg/m2的女性被随机分为接受 162mg 阿司匹林、40mg 普伐他汀或两者联合治疗。研究药物每天服用 2 周，然后进行为期 2 周的洗脱期随访。参与者在基线、干预期后和洗脱期后提供血液样本。主要结局为每个时间点血液成分中炎症和脂质生物标志物的变化。
分别有 9、8 和 8 名女性随机分配至阿司匹林、普伐他汀和联合组。在阿司匹林、普伐他汀和联合组中，有 8、7 和 7 名女性的生物标志物数据在基线时可用，对其进行了分析。所有组的高敏 C 反应蛋白（hsCRP）水平在治疗后均降低，且在普伐他汀和联合组中在洗脱后继续降低。整个样本和基线 hsCRP 为 2-10mg/L 的女性之间的结果一致。普伐他汀和联合组治疗后低密度脂蛋白胆固醇（LDL-C）降低，洗脱后略有升高。
我们的结果初步表明，短期阿司匹林和普伐他汀治疗可降低超重和肥胖育龄女性的 hsCRP 和 LDL-C，包括那些低水平炎症的女性。由于这些短期疗效，这些药物可能会改善该人群的不孕治疗结局，我们将在未来的随机试验中评估这一点。
