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Simvastatin may boost benefits of metformin in women with PCOS
Kazerooni T. Fertil Steril. 2010;94:2208-2213.
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Adding simvastatin to metformin effectively improved lipid profiles, reduced hyperandrogenemia and enhanced insulin sensitivity in women with polycystic ovary syndrome, according to recent data.
For 12 weeks, researchers randomly assigned 42 women with PCOS to receive a 20-mg daily dose of simvastatin in addition to three 500-mg daily doses of metformin. Another 42 women with PCOS served as controls and received placebo in place of simvastatin.
At the study’s conclusion, women assigned to metformin plus simvastatin experienced a sharper decline in total cholesterol as compared with those in the placebo group (29.5% vs. 4.2%; P<.001). Further benefits observed in the combination therapy arm included an 18.5% reduction in LDL levels and a 14% boost in HDL levels. Conversely, women assigned to placebo only demonstrated a 1.5% decrease in LDL levels and a 1% increase in HDL levels.
Similarly, women who received metformin plus simvastatin had a 32% decline in triglycerides, whereas those receiving placebo only experienced a 5.3% decrease (P<.001).
Although average serum testosterone levels dropped in both groups, the 25.5% decrease observed in the combination treatment group exceeded the 16.8% decline observed in the placebo arm (P=.001).
The researchers said women assigned to combination therapy experienced a considerably greater reduction in luteinizing hormone compared with those assigned to placebo (45.5% vs. 6.7%; P=.001). The luteinizing hormone to follicle-stimulating hormone ratio also decreased by 38.3% in the combination therapy group, whereas this number rose by 4.4% in the placebo group (P=.009).
Insulin sensitivity improved by 3.2% in the treatment arm and 2.7% in the placebo arm; however, the researchers noted that these differences were not significant.
“This report demonstrates that the combination of metformin and simvastatin could lead to a better reduction of testosterone and luteinizing hormone levels and thus reversing the luteinizing hormone to FSH ratio, lipid profile, and insulin resistance in patients with PCOS and may be an appropriate management option for patients with PCOS,” the researchers wrote.
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