title: An investigation into the therapeutic effects of statins with metformin on polycystic ovary syndrome: a meta-analysis of randomised controlled trials.
abstract: To investigate the therapeutic effects of statins with metformin on polycystic ovary syndrome (PCOS).
  
  
  
  Endocrinology department.
  
  
  
  MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched until October 2014. Studies comparing statins and placebo, as well as the combination of statins and metformin and metformin alone, were included in the analysis.
  
  
  
  Data were independently extracted by two researchers; any convergence was resolved by a third reviewer.
  
  
  
  The following properties were extracted from the qualified trials to identify the effects of statins: clinical variables, metabolic characteristics, hormone outcomes, sign of inflammation, glucose parameters and insulin outcomes.
  
  
  
  Data from four trials comparing statin and metformin with metformin alone were analysed. The combination of statins and metformin decreases the levels of C reactive protein (standardised mean difference (SMD) -0.91; 95% CI -1.81 to -0.02; p=0.046), triglyceride (SMD -1.37; 95% CI -2.46 to -0.28; p=0.014), total cholesterol (SMD -1.28; 95% CI -1.59 to -0.97; p=0.000) and low-density lipoprotein (LDL) cholesterol (SMD -0.74; 95% CI -1.03 to -0.44; p=0.000). However, the combined therapy fails to reduce fasting insulin (SMD -0.92; 95% CI -2.07 to 0.24; p=0.120), homeostasis model assessment of insulin resistance (SMD -1.15; 95% CI -3.36 to 1.06; p=0.309) and total testosterone (SMD -1.12; 95% CI -2.29 to 0.05; p=0.061). Analysis of the five trials comparing statin with placebo shows that statin monotherapy reduces LDL-cholesterol, triglyceride and total cholesterol.
  
  
  
  Combined statin and metformin therapy can improve lipid and inflammation parameters, but cannot effectively improve insulin sensitivity and reduce hyperandrogenism in women with PCOS. A large-scale randomised controlled study must be conducted to ascertain the long-term effects of the therapy.
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Cai
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Haixia
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Pin
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Xia
authors.affiliation: Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, People's Republic of China.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Wang
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013739:Testosterone / Q000097:blood; D014280:Triglycerides / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides; D013739:Testosterone; D002097:C-Reactive Protein; D008687:Metformin
keywords: GENERAL MEDICINE (see Internal Medicine)
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