title: Statin therapy worsens insulin sensitivity in women with polycystic ovary syndrome (PCOS): a prospective, randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Statins have been shown to improve hyperandrogenism in women with polycystic ovary syndrome (PCOS). However, their use has also been associated with impairment of glucose metabolism and an increased risk of type 2 diabetes mellitus. Because women with PCOS are prone to disturbances in glucose metabolism, statin therapy could also have negative effects.
  
  
  OBJECTIVE
  Our objective was to explore the effects of atorvastatin therapy on hormonal and metabolic parameters in women with PCOS.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled 6-month follow-up study conducted at Oulu University Hospital, Finland.
  
  
  METHODS
  Women with PCOS (Rotterdam criteria) were treated with atorvastatin (20 mg/d, n = 15) or placebo (n = 13) for 6 months.
  
  
  METHODS
  Fasting serum samples were collected at baseline and at 3 and 6 months. Oral and iv glucose tolerance tests were performed at 0 and 6 months.
  
  
  METHODS
  Androgen secretion and glucose metabolism were measured.
  
  
  RESULTS
  Fasting levels and area under the curve of insulin increased significantly and insulin sensitivity (insulinogenic and Matsuda indexes) decreased during 6 months of atorvastatin therapy. Serum levels of dehydroepiandrosterone sulfate decreased in the atorvastatin group, whereas no change was observed in serum testosterone levels. Levels of C-reactive protein, total and low-density lipoprotein-cholesterol, and triglycerides decreased significantly during statin therapy.
  
  
  CONCLUSIONS
  Atorvastatin therapy improves chronic inflammation and lipid profile, but it impairs insulin sensitivity in women with PCOS. Because women with PCOS have an increased risk of developing type 2 diabetes mellitus, the results suggest that statin therapy should be initiated on the basis of generally accepted criteria and individual risk assessment of cardiovascular disease, and not only because of PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Central Hospital and Helsinki University, P.O. Box 140, 00029 HUS, Finland. juha.tapanainen@helsinki.fi.
authors.forename: Johanna
authors.initials: J
authors.lastname: Puurunen
authors.forename: Terhi
authors.initials: T
authors.lastname: Piltonen
authors.forename: Katri
authors.initials: K
authors.lastname: Puukka
authors.forename: Aimo
authors.initials: A
authors.lastname: Ruokonen
authors.forename: Markku J
authors.initials: MJ
authors.lastname: Savolainen
authors.forename: Risto
authors.initials: R
authors.lastname: Bloigu
authors.forename: Laure
authors.initials: L
authors.lastname: Morin-Papunen
authors.forename: Juha S
authors.initials: JS
authors.lastname: Tapanainen
mesh_terms: D000328:Adult; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000069059:Atorvastatin; D015992:Body Mass Index; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000139:chemically induced; D005951:Glucose Tolerance Test; D006538:Heptanoic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D017588:Hyperandrogenism / Q000209:etiology / Q000517:prevention & control; D006946:Hyperinsulinism / Q000139:chemically induced; D006949:Hyperlipidemias / Q000209:etiology / Q000517:prevention & control; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000726:Androgen Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin