Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Pharmacology. 2023;108(5):451-459. doi: 10.1159/000531321. Epub 2023 Aug 3.
Polycystic ovary syndrome (PCOS) is a frequent endocrinopathy in young women with significantly increased cardiometabolic risk. Siblings of women with this disorder are at increased risk of insulin resistance and androgen excess. The current study was aimed at investigating cardiometabolic effects of atorvastatin in sisters of women with PCOS.
This prospective observational study compared two age-, body mass index-, blood pressure-, and plasma lipid-matched groups of women with hypercholesterolemia: sisters of PCOS probands (group A) and unrelated control subjects (group B), receiving atorvastatin (40 mg daily). Plasma lipids, glucose homeostasis markers, concentrations of sex hormones, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen and uric acid, and the urinary albumin-to-creatinine ratio (UACR) were measured before entering the study and 6 months later.
Both groups differed in the degree of insulin resistance, testosterone, free androgen index (FAI), circulating levels of hsCRP and homocysteine, and UACR. There were no between-group differences in the impact of atorvastatin on plasma lipids. Despite reducing hsCRP and homocysteine in both groups of women, the effect on these biomarkers was stronger in group B than in group A. Only in group B, atorvastatin did reduce fibrinogen, uric acid, and UACR. Only in group A, atorvastatin did worsen insulin sensitivity and tended to reduce testosterone and FAI. The impact of atorvastatin on hsCRP, homocysteine, fibrinogen, uric acid, and UACR inversely correlated with testosterone and FAI.
The obtained results suggest that sisters of women with PCOS may benefit to a lesser degree from atorvastatin treatment than other women.
多囊卵巢综合征（PCOS）是年轻女性中常见的内分泌疾病，伴有显著增加的心血管代谢风险。患有这种疾病的女性的姐妹患胰岛素抵抗和雄激素过多的风险增加。本研究旨在研究阿托伐他汀对多囊卵巢综合征女性姐妹的心血管代谢影响。
本前瞻性观察研究比较了两组患有高胆固醇血症的年龄、体重指数、血压和血浆脂质匹配的女性：多囊卵巢综合征患者的姐妹（A 组）和无关的对照组（B 组），均接受阿托伐他汀（40mg 每日）治疗。在进入研究之前和 6 个月后测量血浆脂质、葡萄糖稳态标志物、性激素浓度、高敏 C 反应蛋白（hsCRP）、同型半胱氨酸、纤维蛋白原和尿酸以及尿白蛋白/肌酐比值（UACR）。
两组在胰岛素抵抗程度、睾丸酮、游离雄激素指数（FAI）、循环 hsCRP 和同型半胱氨酸以及 UACR 方面存在差异。阿托伐他汀对两组女性的血浆脂质影响无组间差异。尽管阿托伐他汀降低了两组女性的 hsCRP 和同型半胱氨酸，但在 B 组的作用强于 A 组。只有在 B 组，阿托伐他汀降低了纤维蛋白原、尿酸和 UACR。只有在 A 组，阿托伐他汀降低了胰岛素敏感性，并有降低睾丸酮和 FAI 的趋势。阿托伐他汀对 hsCRP、同型半胱氨酸、纤维蛋白原、尿酸和 UACR 的影响与睾丸酮和 FAI 呈负相关。
研究结果表明，与其他女性相比，多囊卵巢综合征女性的姐妹可能从阿托伐他汀治疗中获益较小。
