It has been shown that there is an increase in oxidative stress in polycystic ovary syndrome (PCOS). Statins are considered to have a pleiotropic effect other than their lipid-lowering effect. These effects may be mediated in part by reducing oxidative stress. Methods: This randomized, double-blind, placebo-controlled study was conducted to assess the effect of atorvastatin on serum malondialdehyde (MDA) concentrations as a marker of oxidative stress in patients with PCOS. Forty

more »

... patients with PCOS were randomized to either atorvastatin 20 mg daily or placebo for 3 months. A 3-month extension study for both groups of patients was undertaken with metformin 1500 mg daily after completing initial 3 months of atorvastatin or placebo. Results : There was a significant decrease of MDA concentrations with atorvastatin [mean (SEM)] [0.29 (0.04) vs. 0.25 (0.02) mol/liter; P Ͻ 0.01] compared with placebo [0.28 (0.02) vs. 0.29 (0.12) mol/liter; P ϭ 0.52]. Three months treatment with metformin resulted in further reduction of MDA levels with atorvastatin compared with baseline [0.25 (0.02) baseline vs. 0.23 (0.03) mol/liter for atorvastatin treated; P ϭ 0.02]. There was also a significant correlation between the reduction in MDA with a reduction in high-sensitivity C-reactive protein (r ϭ 0.71, P Ͻ 0.01), an increase in 25-hydroxyvitamin D (25OHD; r ϭ Ϫ0.68, P ϭ 0.02), and a reduction in testosterone levels (r ϭ 0.63, P ϭ 0.01). Multiple linear regression analysis revealed ⌬25OHD, ⌬C-reactive protein, and ⌬testosterone were independent predictors of changes in MDA after atorvastatin treatment. No correlation was observed between the reductions in serum MDA concentrations with changes in the lipid parameters. Conclusions: Twelve weeks of atorvastatin led to a significant reduction in oxidative stress as determined by MDA concentrations among patients with polycystic ovary syndrome that was independently predicted by changes in testosterone, 25OHD, and high-sensitivity C-reactive protein. (J Clin Endocrinol Metab 97: 3951-3955, 2012) Abbreviations: CRP, C-reactive protein; HOMA-IR, homeostasis model assessment insulin resistance index; hsCRP, high-sensitivity CRP; MDA, malondialdehyde; 25OHD, 25-hydroxyvitamin D; PCOS, polycystic ovary syndrome.