Abstract
Several clinical studies showed that statins were potential to treat polycystic ovary syndrome (PCOS). Through comprehensive search PubMed, EMBASE, the Web of Science, BIOSIS, the ClinialTrails.gov, and the Cochrane Library database up to 14 Feb 2020, we identified the randomized controlled trials about the treatment of statins on hyperandrogenism in PCOS women, and performed a systematic review and meta-analysis. The quality of the included studies was assessed by the Cochrane risk of bias tool and the Jadda score. Subgroup analysis and sensitivity analysis were conducted to analyze the pooled results. Nine trials included 682 PCOS patients were identified. Statins showed a significant potential to reduce testosterone (SMD = -0.47; 95% CI, − 0.76−− 0.18; P = 0.002) and dehydroepiandrosterone (SMD = -0.51; 95% CI, − 0.97−− 0.05; P = 0.03) levels, compared to the control treatments. The cutaneous symptoms hirsutism (SMD = -0.61; 95% CI, − 1.13−− 0.10; P = 0.02) and acne (SMD = -0.92; 95% CI, − 1.49−− 0.34; P = 0.002) were significantly improved by statins in PCOS women. Subgroup analysis showed that the two types of statins, and the different control treatments as well, presented no significantly different effect on testosterone and dehydroepiandrosterone. Sensitivity analysis confirmed the stability of the findings from the meta-analysis. In conclusion, statin treatment could significantly reduce androgen levels and improve cutaneous manifestations of hyperandrogenism of PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, irregular menses, hirsutism, anovulation, dyslipidemia, hypertension, insulin resistance, and polycystic ovaries when other etiologies are excluded [1,2,3]
Study characteristics and quality evaluation In the 9 randomized controlled trials (RCTs), 347 out of 682 PCOS patients were involved in the statin treatment group and the other 335 patients in the control treatment group
Two kinds of statins were used in the 9 RCTs, simvastatin for 6 studies [19,20,21, 23, 24, 27] and atorvastatin for three studies [22, 25, 26, 36]
Summary
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, irregular menses, hirsutism, anovulation, dyslipidemia, hypertension, insulin resistance, and polycystic ovaries when other etiologies are excluded [1,2,3]. There are 10–15% of reproductive-aged women affected with PCOS [4]. Up to 60–80% of women with PCOS appear hyperandrogenism [1]. Hyperandrogenism is a medical condition characterized by excessive levels of androgens in the periphery or systemically. Hyperandrogenism corresponds to an important criterion for the diagnosis of PCOS. PCOS symptoms of hirsutism, seborrhea, acne, androgenetic alopecia, and virilization are caused by hyperandrogenism [5,6,7]. The cutaneous symptoms of hirsutism, acne cause great psychological distress for patients [8, 9].
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