Possible beneficial effect of statin in women with poly cystic ovarian syndrome (PCOs)
Main Article Content
Keywords
Polycystic ovary syndrome, ovary polycystic disease, PCOS Statin, Atorvastatin, Simvastatin, Rosuvastatin, Lovastatin, Mevastatin, Pravastatin
Abstract
Statins, as lipid-lowering agents are likely not only to improve the dyslipidaemia associated with polycystic ovary syndrome but may also exert other beneficial metabolic and endocrine effects. Aim of the study: Reviewing, assessing the possible beneficial effect of statins therapy in women with poly cystic ovarian syndrome conceive. Search method: Electronic searching of databases including published Cochrane library, Menstrual Disorders and Subfertility Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) , MEDLINE ,EMBASE , PubMed in English language up to February 2016 using the following keywords: Polycystic ovary syndrome, ovary polycystic disease, PCOS Statin, Atorvastatin, Simvastatin, Rosuvastatin, Lovastatin, Mevastatin, Pravastatin. Inclusion Criteria: randomised studies in which any statin was compared with placebo or other agent(s), or any statin in combination with another drug was compared to another class of drug alone in women with PCOS are included , non randomized controlled trials were excluded . Data collection: selecting trials that have the inclusion criteria from the search results , printed and collecting data from each study for results presented using , excluded studies that did not meet the inclusion criteria Main results: Four trials fulfilled the criteria for inclusion. They comprised a total of 244 women with PCOS receiving 12 weeks or 6 weeks of treatment. Two trials (184 women randomised) studied the effects of simvastatin and two trials (60 women randomised) studied the effects of atorvastatin. There was no good evidence that statins improved menstrual regularity, spontaneous ovulation rate, hirsutism or acne, either alone or in combination with the combined oral contraceptive pill (OCP). Nor were there any significant effects on body mass index (BMI). Statins were effective in lowering testosterone levels (nmol/L) (mean difference (MD) -0.90, 95% CI -1.18 to -0.62, P < 0.00001, 3 RCTs, 105 women) when used alone or with the OCP. Statins also improved total cholesterol, low-density lipoprotein (LDL) and triglycerides but had no significant effect on high-density lipoprotein (HDL) levels, high sensitivity (HS) Creactive protein (HS-CRP), fasting insulin or homeostatic model assessment (HOMA) insulin resistance. No serious adverse events were reported in any of the included studies. Conclusions: Statins are effective in improving the lipid profile of women with PCOS, Statins, either alone or with the oral contraceptive pill (OCP), also improve the biochemical parameter of hyperandrogenaemia (reducing the level of total testosterone) but There is no good evidence that statins improve menstrual regularity, ovulation rate, hirsutism or acne in women with polycystic ovary syndrome (PCOS), and there are no data on the long term safety of statins in women with PCOS, no data are available about the long-term cardiovascular risk profile in women with PCOS
References
1. Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS) arguably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrin Metab 1999;84:1897–9.
2. Azziz R, Carmina E, Dawailly D, et al. Position statement: Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrin Metab 2006;91(11):4237–45.
3. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary
syndrome. Fertil Steril 2004;81:19–25.
4. Urbanek M. The genetics of the polycystic ovary syndrome. Nat Clin Pract Endocrinol Metab 2007;3:103–11. [PubMed: 17237837]
5. Lunde O, Magnus P, Sandvik L, Hoglo S. Familial clustering in polycystic ovarian syndrome. Gynecol Obstet Invest 1989;28:23–30. [PubMed: 2777131]
6. DeVane GW, Czekala NM, Judd HL, Yen SS. Circulating gonadotropins, estrogens, and androgens in polycystic ovarian disease. Am J Obstet Gynecol 1975;121:496. [PubMed: 125040]
7. Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endo Rev 2000;21:347–62.
8. Choudhry R, Hodgins MB, Van der Kwast T, Brinkman AO, Boersma WJ. Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair grown, sebacious glands, and sweat glands. J Endocrinol 1992;133:467–75. [PubMed: 1613448]
9. Baille A, Calman K, Milne J. Histochemical distribution of hydroxysteroid dehydrogenases in human skin. Br J Derm 1965;7:610–6.
10. Moghetti P, Toscano V. Treatment of hirsutism and acne in hyperandrogenism. Best Pract Res Clin Endocrinol Metab 2006;20(2):221–34. [PubMed: 16772153]
11. Amowitz LL, Sobel BE. Cardiovascular consequences of polycystic ovary syndrome. Endocrinol Metab Clin North Am 1999;28:439–58. [PubMed: 10352928]
12. Gambineri A, Pelusi C, Genghini S, et al. Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome. Clin Endocrinol 2004;60:241–9.
13. Diamanti-Kandarakis E, Mitrakou A, Raptis S, Tolis G, Duleba AJ. The effect of a pure anti-androgen
receptor blocker flutamide on the lipid profile in the polycystic ovary syndrome. J Clin Endocrinol Metab 1998;83:2699–705. [PubMed: 9709934]
14. Chen M-J, Yang W-S, Yang J-H, Chen C-L, Ho H-N, Yang Y-S. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome. Hypertension 2007;49:1442–7. [PubMed: 17389259]
15. Speiser PW, Serrat J, New MI, Gertner JM. Insulin insensitivity in adrenal hyperplasia due to nonclassical steroid 21-hydroxylase deficiency. J Clin Endocrinol Metab 1992;75(6):1421–4. [PubMed: 1464643]
16. Diamond MP, Grainger D, Diamond MC, Sherwin RS, Defronzo RA. Effects of methyltestosterone on insulin secretion and sensitivity in women. J Clin Endocrinol Metab 1998;83(12):4420–5. [PubMed: 9851788]
17. Shaw LJ, Bairey Merz CN, Azziz R, et al. Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health--National Heart, Lung, and Blood Institute sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008;93(4):1276–84. [PubMed: 18182456]
18. Hull MG. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol 1987;1:235–45. [PubMed: 3140583]
19. Wild S, Pierpoint T, Jacobs H, McKeigue P. Long-term consequences of polycystic ovary syndrome:results of a 31 year follow-up study. Hum Fert 2000;3(2):101–5.
20. Homburg R, Armar NA, Eshel A, Adams J, Jacobs HS. Influence of serum luteinising hormone concentrations on ovulation, conception and early pregnancy loss in polycystic ovary syndrome. Br Med J 1988;297:1024–6. [PubMed: 3142595]
21. Sagle M, Bishop K, Ridley N, et al. Recurrent early miscarriage and polycystic ovaries. Br Med J 1988;297:1027–8. [PubMed: 3142597]
22. Lunde O, Tanbo T. Polycystic ovary syndrome: A follow-up study on diabetes mellitus, cardiovascular disease, and malignancy 15-25 years after ovarian wedge resection. Gynecol Endocrinol 2007;23(12):704–9. [PubMed: 18075845]
23. Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003;361:1810–2. [PubMed: 12781553]
24. Pillay OC, Te Fong LF, Crow JC, et al. The association between polycystic ovaries and endometrial cancer. Hum Reprod 2006;21:924–9. [PubMed: 16361289]
25. Ratts VS, Pauls RN, Pinto AB, Kraja A, Williams DB, Odem RR. Risk of multiple gestation after ovulation induction in polycystic ovary syndrome. J Reprod Med 2007;52(10):896–900. [PubMed: 17977162]
26. Lin K, Coutifaris C. In vitro fertilization in the polycystic ovary syndrome patient: An update. Clin Obstet Gynecol 2007;50(1):268–76. [PubMed: 17304041]
27. Tummon I, Gavrilova-Jordan L, Allemand MC, Session D. Polycystic ovaries and ovarian hyperstimulation syndrome: a systematic review. Acta Obstet Gynecol Scand 2005;84:611–6. [PubMed: 15954867]
28. Dokras A. Cardiovascular disease risk factors in polycystic ovary syndrome. Semin Reprod Med 2008;26(1):39–44. [PubMed: 18181081]
29. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence and predictors of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999;22:141–6. [PubMed: 10333916]
30. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999;84:165–9. [PubMed: 9920077]
31. Ehrmann DA, Kasza K, Azziz R, Legro RS, Ghazzi MN. Effect of race and family history of type 2 diabetes on metabolic status of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:66–71. [PubMed: 15507516]
32. Palmert MR, Gordon CM, Kartashov AI, Legro RS, Emans SJ, Dunaif A. Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:1017–23. [PubMed: 11889155]
33. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001;91(3):436–40. [PubMed: 11236410]
34. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004;103(2):219–24. [PubMed: 14754687]
35. Weiss JL, Malone FD, Emig D, et al. Obesity, obstetric complications and cesarean delivery rate—a population-based screening study. Am J Obstet Gynecol 2004;190(4):1091–7. [PubMed: 15118648]
36. Robinson HE, O’Connell CM, Joseph KS, McLeod NL. Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol 2005;106(6):1357–64. [PubMed: 16319263]
37. Myles TD, Gooch J, Santolaya J. Obesity as an independent risk factor for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol 2002;100(5 Pt 1):959–64. [PubMed: 12423861]
38. D’Angelo R. Anesthesia-related maternal mortality: a pat on the back or a call to arms? Anesthesiology 2007;106(6):1082–4. [PubMed: 17525579]
39. Wali A, Suresh MS. Maternal morbidity, mortality, and risk assessment. Anesthesiol Clin 2008;26
(1):197–230. ix. [PubMed: 18319189]
40. Kabiru W, Raynor BD. Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol 2004;191(3):928–32. [PubMed: 15467566]
41. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985-2003. Anesthesiology 2007;106(6):1096–104. [PubMed: 17525583]
42. Hollander MH, Paarlberg KM, Huisjes AJ. Gestational diabetes: a review of the current literature and guidelines. Obstet Gynecol Surv 2007;62(2):125–36. [PubMed: 17229329]
43. Boomsma CM, Fauser BC, Macklon NS. Pregnancy complications in women with polycystic ovary syndrome. Semin Reprod Med 2008;26(1):72–84. [PubMed: 18181085]
44. Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD. Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest 1996;97(11):2601–10. [PubMed: 8647954]
45. Dokras A, Jagasia DH, Maifeld M, Sinkey CA, VanVoorhis BJ, Haynes WG. Obesity and insulin resistance but not hyperandrogenism mediates vascular dysfunction in women with polycystic ovary syndrome. Fertil Steril 2006;86(6):1702–9. [PubMed: 17067587]
46. Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001;103(10):1410–5. [PubMed: 11245645]
47. Brehm A, Pfeiler G, Pacini G, Vierhapper H, Roden M. Relationship between serum lipoprotein ratios and insulin resistance in obesity. Clin Chem 2004;50(12):2316–22. [PubMed: 15459091]
48. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003;139(10):802–9. [PubMed: 14623617]
49. Wild RA, Applebaum-Bowden D, Demers LM, et al. Lipoprotein lipids in women with androgen excess: independent associations with increased insulin and androgens. Clin Chem 1990;36:283–9. [PubMed: 2406040]
50. Dahlgren E, Johansson S, Lindstedt G, et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril 1992;57:505–13. [PubMed: 1740195]
51. Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A. Polycystic ovary syndrome and risk for myocardial infarction. Acta Obstet Gynecol Scand 1992;71:599–604. [PubMed: 1336918]
52. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1985;61:94 [PubMed: 4044782]
53. Mahabeer S, Naidoo C, Norman RJ, Jialal I, Reddi K, Joubert SM. Metabolic profiles and lipoprotein
lipid concentrations in non-obese and obese patients with polycystic ovarian disease. Horm Metab Res 1990;22:537–40. [PubMed: 2079317]
54. Birdsall MA, Farquhar CM, White HD. Association between polycystic ovaries and extent of coronary artery disease in women having cardiac catheterization. Ann Intern Med 1997;126:32–5. [PubMed: 8992921]
55. Conway GS, Agrawal R, Betteridge DJ, Jacobs HS. Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol 1992;37:119–25.
56. Yilmaz M, Bukan N, Ayvaz G, et al. The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome. Hum Reprod 2005;20(12): 3333–40. [PubMed: 16123091]
57. Loverro G, Lorusso F, Mei L, Depalo R, Cormio G, Selvaggi L. The plasma homocysteine levels are increased in polycystic ovary syndrome. Gynecol Obstet Invest 2002;53:157–62. [PubMed: 12053100]
58. Randeva H, Lewandowski KC, Drzewoski J, et al. Exercise decreases plasma total homocysteine in
overweight young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:4496– 501. [PubMed: 12364425]
59. Vrbikova J, Bicikova M, Tallova J, Hill M, Starka L. Homocysteine and steroid levels in metformintreated women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2002;110:74 7. [PubMed: 11928069]
60. Clark R, Daly L, Robinson K, et al. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med 1991;324:1149–55. [PubMed: 2011158]
61. Kanani P, Sinkey C, Browning R, Allaman M, Knapp H, Haynes W. Role of oxidant stress in endothelial dysfunction produced by experimental hyperhomocysteinemia in humans. Circulation 1999;100:1161–8. [PubMed: 10484535]
62. Lakhani K, Seifalian AM, Hardiman P. Impaired carotid viscoelastic properties in women with polycystic ovaries. Circulation 2002;106:81–5. [PubMed: 12093774]
63. Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001;103:1410–5. [PubMed: 11245645]
64. Shroff R, Kerchner A, Maifeld M, Van Beek EJR, Jagasia D, Dokras A. Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis. J Clin Endocrin Metab 2007;92(12):4609–14.
65. Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD. Prediction of coronary events with electron beam computed tomography. J Am Coll Cardol 2000;36:1253–60.
66. Schneider JG, Tompkins C, Blumenthal RS, Mora S. The metabolic syndrome in women. Cardiol Rev 2006;14(6):286–91. [PubMed: 17053375]
67. Third report of the National Cholesterol Education Program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). NIH Publication; 2001. Health NIo01-3670
68. Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:1929–35. [PubMed: 15623819]
69. Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005;106(1):131–7. [PubMed: 15994628]
70. Reaven GM. Banting lecture: Role of insulin resistance in human disease. Diabetes 1988;37:1597–
607.
71. Salley KE, Wickham EP, Cheang KI, Essah PA, Karjane NW, Nestler JE. Glucose intolerance in polycystic ovary syndrome. A position statement of the Androgen Excess Society. J Clin Endocrin Metab 2007;92(12):4546–56.
72. Pierpoint T, McKeigue P, Isaacs AJ, Wild SH, Jacobs H. Mortality of women with polycystic ovary
syndrome at long-term follow-up. J Clin Epidemiol 1998;51:581–6. [PubMed: 9674665]
73. Anonymous. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383–9. [PubMed: 7968073]
74. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996;335:1001–9. [PubMed: 8801446]
75. Shepard J, Cobbe SM, Ford I, et al. West of Scotland Coronary Prevention Study Group. Prevention
of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995;333:1301–7. [PubMed: 7566020]
76. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;(279)
77.Raja-Khan N, Kunselman AR, Hogeman CS, Stetter CM, Demers LM, Legro RS. Effects of atorvastatin on vascular function, inflammation, and androgens in women with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled trial. Fertility and Sterility 2011;95(5): 1849–52.
78. Sathyapalan T, Kilpatrick ES, Coady A-M, Atkin SL. Atorvastatin pretreatment augments the effect of metformin in patients with polycystic ovary syndrome (PCOS). Clinical Endocrinology 2010;72(4):566–8.
79. Banaszewska B, Pawelczyk L, Spaczynski RZ, Dziura J, Duleba AJ. Effects of simvastatin and oral contraceptive agent on polycystic ovary syndrome: prospective, randomized, crossover trial. Journal of Clinical Endocrinology and Metabolism 2007;92(2):456–61.80.
80.Banaszewskaa B, Pawelczyka L, Spaczynskia R, Duleba AJ. Comparison of effects of simvastatin and metformin in women with PCOS: a randomized trial. Fertility and Sterility 2007;88:574.
81.Plakogiannis, R, Cohen, H, Taft, D. Effects of morning versus evening administration of atorvastatin in patients with hyperlipidemia. Am J Health Syst Pharm. 2005; 62(23):2491-4.
2. Azziz R, Carmina E, Dawailly D, et al. Position statement: Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrin Metab 2006;91(11):4237–45.
3. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary
syndrome. Fertil Steril 2004;81:19–25.
4. Urbanek M. The genetics of the polycystic ovary syndrome. Nat Clin Pract Endocrinol Metab 2007;3:103–11. [PubMed: 17237837]
5. Lunde O, Magnus P, Sandvik L, Hoglo S. Familial clustering in polycystic ovarian syndrome. Gynecol Obstet Invest 1989;28:23–30. [PubMed: 2777131]
6. DeVane GW, Czekala NM, Judd HL, Yen SS. Circulating gonadotropins, estrogens, and androgens in polycystic ovarian disease. Am J Obstet Gynecol 1975;121:496. [PubMed: 125040]
7. Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endo Rev 2000;21:347–62.
8. Choudhry R, Hodgins MB, Van der Kwast T, Brinkman AO, Boersma WJ. Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair grown, sebacious glands, and sweat glands. J Endocrinol 1992;133:467–75. [PubMed: 1613448]
9. Baille A, Calman K, Milne J. Histochemical distribution of hydroxysteroid dehydrogenases in human skin. Br J Derm 1965;7:610–6.
10. Moghetti P, Toscano V. Treatment of hirsutism and acne in hyperandrogenism. Best Pract Res Clin Endocrinol Metab 2006;20(2):221–34. [PubMed: 16772153]
11. Amowitz LL, Sobel BE. Cardiovascular consequences of polycystic ovary syndrome. Endocrinol Metab Clin North Am 1999;28:439–58. [PubMed: 10352928]
12. Gambineri A, Pelusi C, Genghini S, et al. Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome. Clin Endocrinol 2004;60:241–9.
13. Diamanti-Kandarakis E, Mitrakou A, Raptis S, Tolis G, Duleba AJ. The effect of a pure anti-androgen
receptor blocker flutamide on the lipid profile in the polycystic ovary syndrome. J Clin Endocrinol Metab 1998;83:2699–705. [PubMed: 9709934]
14. Chen M-J, Yang W-S, Yang J-H, Chen C-L, Ho H-N, Yang Y-S. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome. Hypertension 2007;49:1442–7. [PubMed: 17389259]
15. Speiser PW, Serrat J, New MI, Gertner JM. Insulin insensitivity in adrenal hyperplasia due to nonclassical steroid 21-hydroxylase deficiency. J Clin Endocrinol Metab 1992;75(6):1421–4. [PubMed: 1464643]
16. Diamond MP, Grainger D, Diamond MC, Sherwin RS, Defronzo RA. Effects of methyltestosterone on insulin secretion and sensitivity in women. J Clin Endocrinol Metab 1998;83(12):4420–5. [PubMed: 9851788]
17. Shaw LJ, Bairey Merz CN, Azziz R, et al. Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health--National Heart, Lung, and Blood Institute sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008;93(4):1276–84. [PubMed: 18182456]
18. Hull MG. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol 1987;1:235–45. [PubMed: 3140583]
19. Wild S, Pierpoint T, Jacobs H, McKeigue P. Long-term consequences of polycystic ovary syndrome:results of a 31 year follow-up study. Hum Fert 2000;3(2):101–5.
20. Homburg R, Armar NA, Eshel A, Adams J, Jacobs HS. Influence of serum luteinising hormone concentrations on ovulation, conception and early pregnancy loss in polycystic ovary syndrome. Br Med J 1988;297:1024–6. [PubMed: 3142595]
21. Sagle M, Bishop K, Ridley N, et al. Recurrent early miscarriage and polycystic ovaries. Br Med J 1988;297:1027–8. [PubMed: 3142597]
22. Lunde O, Tanbo T. Polycystic ovary syndrome: A follow-up study on diabetes mellitus, cardiovascular disease, and malignancy 15-25 years after ovarian wedge resection. Gynecol Endocrinol 2007;23(12):704–9. [PubMed: 18075845]
23. Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003;361:1810–2. [PubMed: 12781553]
24. Pillay OC, Te Fong LF, Crow JC, et al. The association between polycystic ovaries and endometrial cancer. Hum Reprod 2006;21:924–9. [PubMed: 16361289]
25. Ratts VS, Pauls RN, Pinto AB, Kraja A, Williams DB, Odem RR. Risk of multiple gestation after ovulation induction in polycystic ovary syndrome. J Reprod Med 2007;52(10):896–900. [PubMed: 17977162]
26. Lin K, Coutifaris C. In vitro fertilization in the polycystic ovary syndrome patient: An update. Clin Obstet Gynecol 2007;50(1):268–76. [PubMed: 17304041]
27. Tummon I, Gavrilova-Jordan L, Allemand MC, Session D. Polycystic ovaries and ovarian hyperstimulation syndrome: a systematic review. Acta Obstet Gynecol Scand 2005;84:611–6. [PubMed: 15954867]
28. Dokras A. Cardiovascular disease risk factors in polycystic ovary syndrome. Semin Reprod Med 2008;26(1):39–44. [PubMed: 18181081]
29. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence and predictors of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999;22:141–6. [PubMed: 10333916]
30. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999;84:165–9. [PubMed: 9920077]
31. Ehrmann DA, Kasza K, Azziz R, Legro RS, Ghazzi MN. Effect of race and family history of type 2 diabetes on metabolic status of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:66–71. [PubMed: 15507516]
32. Palmert MR, Gordon CM, Kartashov AI, Legro RS, Emans SJ, Dunaif A. Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:1017–23. [PubMed: 11889155]
33. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001;91(3):436–40. [PubMed: 11236410]
34. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004;103(2):219–24. [PubMed: 14754687]
35. Weiss JL, Malone FD, Emig D, et al. Obesity, obstetric complications and cesarean delivery rate—a population-based screening study. Am J Obstet Gynecol 2004;190(4):1091–7. [PubMed: 15118648]
36. Robinson HE, O’Connell CM, Joseph KS, McLeod NL. Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol 2005;106(6):1357–64. [PubMed: 16319263]
37. Myles TD, Gooch J, Santolaya J. Obesity as an independent risk factor for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol 2002;100(5 Pt 1):959–64. [PubMed: 12423861]
38. D’Angelo R. Anesthesia-related maternal mortality: a pat on the back or a call to arms? Anesthesiology 2007;106(6):1082–4. [PubMed: 17525579]
39. Wali A, Suresh MS. Maternal morbidity, mortality, and risk assessment. Anesthesiol Clin 2008;26
(1):197–230. ix. [PubMed: 18319189]
40. Kabiru W, Raynor BD. Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol 2004;191(3):928–32. [PubMed: 15467566]
41. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985-2003. Anesthesiology 2007;106(6):1096–104. [PubMed: 17525583]
42. Hollander MH, Paarlberg KM, Huisjes AJ. Gestational diabetes: a review of the current literature and guidelines. Obstet Gynecol Surv 2007;62(2):125–36. [PubMed: 17229329]
43. Boomsma CM, Fauser BC, Macklon NS. Pregnancy complications in women with polycystic ovary syndrome. Semin Reprod Med 2008;26(1):72–84. [PubMed: 18181085]
44. Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD. Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest 1996;97(11):2601–10. [PubMed: 8647954]
45. Dokras A, Jagasia DH, Maifeld M, Sinkey CA, VanVoorhis BJ, Haynes WG. Obesity and insulin resistance but not hyperandrogenism mediates vascular dysfunction in women with polycystic ovary syndrome. Fertil Steril 2006;86(6):1702–9. [PubMed: 17067587]
46. Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001;103(10):1410–5. [PubMed: 11245645]
47. Brehm A, Pfeiler G, Pacini G, Vierhapper H, Roden M. Relationship between serum lipoprotein ratios and insulin resistance in obesity. Clin Chem 2004;50(12):2316–22. [PubMed: 15459091]
48. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003;139(10):802–9. [PubMed: 14623617]
49. Wild RA, Applebaum-Bowden D, Demers LM, et al. Lipoprotein lipids in women with androgen excess: independent associations with increased insulin and androgens. Clin Chem 1990;36:283–9. [PubMed: 2406040]
50. Dahlgren E, Johansson S, Lindstedt G, et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril 1992;57:505–13. [PubMed: 1740195]
51. Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A. Polycystic ovary syndrome and risk for myocardial infarction. Acta Obstet Gynecol Scand 1992;71:599–604. [PubMed: 1336918]
52. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1985;61:94 [PubMed: 4044782]
53. Mahabeer S, Naidoo C, Norman RJ, Jialal I, Reddi K, Joubert SM. Metabolic profiles and lipoprotein
lipid concentrations in non-obese and obese patients with polycystic ovarian disease. Horm Metab Res 1990;22:537–40. [PubMed: 2079317]
54. Birdsall MA, Farquhar CM, White HD. Association between polycystic ovaries and extent of coronary artery disease in women having cardiac catheterization. Ann Intern Med 1997;126:32–5. [PubMed: 8992921]
55. Conway GS, Agrawal R, Betteridge DJ, Jacobs HS. Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol 1992;37:119–25.
56. Yilmaz M, Bukan N, Ayvaz G, et al. The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome. Hum Reprod 2005;20(12): 3333–40. [PubMed: 16123091]
57. Loverro G, Lorusso F, Mei L, Depalo R, Cormio G, Selvaggi L. The plasma homocysteine levels are increased in polycystic ovary syndrome. Gynecol Obstet Invest 2002;53:157–62. [PubMed: 12053100]
58. Randeva H, Lewandowski KC, Drzewoski J, et al. Exercise decreases plasma total homocysteine in
overweight young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:4496– 501. [PubMed: 12364425]
59. Vrbikova J, Bicikova M, Tallova J, Hill M, Starka L. Homocysteine and steroid levels in metformintreated women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2002;110:74 7. [PubMed: 11928069]
60. Clark R, Daly L, Robinson K, et al. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med 1991;324:1149–55. [PubMed: 2011158]
61. Kanani P, Sinkey C, Browning R, Allaman M, Knapp H, Haynes W. Role of oxidant stress in endothelial dysfunction produced by experimental hyperhomocysteinemia in humans. Circulation 1999;100:1161–8. [PubMed: 10484535]
62. Lakhani K, Seifalian AM, Hardiman P. Impaired carotid viscoelastic properties in women with polycystic ovaries. Circulation 2002;106:81–5. [PubMed: 12093774]
63. Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001;103:1410–5. [PubMed: 11245645]
64. Shroff R, Kerchner A, Maifeld M, Van Beek EJR, Jagasia D, Dokras A. Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis. J Clin Endocrin Metab 2007;92(12):4609–14.
65. Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD. Prediction of coronary events with electron beam computed tomography. J Am Coll Cardol 2000;36:1253–60.
66. Schneider JG, Tompkins C, Blumenthal RS, Mora S. The metabolic syndrome in women. Cardiol Rev 2006;14(6):286–91. [PubMed: 17053375]
67. Third report of the National Cholesterol Education Program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). NIH Publication; 2001. Health NIo01-3670
68. Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:1929–35. [PubMed: 15623819]
69. Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005;106(1):131–7. [PubMed: 15994628]
70. Reaven GM. Banting lecture: Role of insulin resistance in human disease. Diabetes 1988;37:1597–
607.
71. Salley KE, Wickham EP, Cheang KI, Essah PA, Karjane NW, Nestler JE. Glucose intolerance in polycystic ovary syndrome. A position statement of the Androgen Excess Society. J Clin Endocrin Metab 2007;92(12):4546–56.
72. Pierpoint T, McKeigue P, Isaacs AJ, Wild SH, Jacobs H. Mortality of women with polycystic ovary
syndrome at long-term follow-up. J Clin Epidemiol 1998;51:581–6. [PubMed: 9674665]
73. Anonymous. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383–9. [PubMed: 7968073]
74. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996;335:1001–9. [PubMed: 8801446]
75. Shepard J, Cobbe SM, Ford I, et al. West of Scotland Coronary Prevention Study Group. Prevention
of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995;333:1301–7. [PubMed: 7566020]
76. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;(279)
77.Raja-Khan N, Kunselman AR, Hogeman CS, Stetter CM, Demers LM, Legro RS. Effects of atorvastatin on vascular function, inflammation, and androgens in women with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled trial. Fertility and Sterility 2011;95(5): 1849–52.
78. Sathyapalan T, Kilpatrick ES, Coady A-M, Atkin SL. Atorvastatin pretreatment augments the effect of metformin in patients with polycystic ovary syndrome (PCOS). Clinical Endocrinology 2010;72(4):566–8.
79. Banaszewska B, Pawelczyk L, Spaczynski RZ, Dziura J, Duleba AJ. Effects of simvastatin and oral contraceptive agent on polycystic ovary syndrome: prospective, randomized, crossover trial. Journal of Clinical Endocrinology and Metabolism 2007;92(2):456–61.80.
80.Banaszewskaa B, Pawelczyka L, Spaczynskia R, Duleba AJ. Comparison of effects of simvastatin and metformin in women with PCOS: a randomized trial. Fertility and Sterility 2007;88:574.
81.Plakogiannis, R, Cohen, H, Taft, D. Effects of morning versus evening administration of atorvastatin in patients with hyperlipidemia. Am J Health Syst Pharm. 2005; 62(23):2491-4.
Article Sidebar
Published
Jan 20, 2023
Article Details
How to Cite
Sarah Al Ramadhan. (2023). Possible beneficial effect of statin in women with poly cystic ovarian syndrome (PCOs). Journal of Population Therapeutics and Clinical Pharmacology, 30(1), 439-453. https://doi.org/10.53555/jptcp.v30i1.4725
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Sarah Al Ramadhan. (2023). Possible beneficial effect of statin in women with poly cystic ovarian syndrome (PCOs). Journal of Population Therapeutics and Clinical Pharmacology, 30(1), 439-453. https://doi.org/10.53555/jptcp.v30i1.4725