Statin is a reasonable treatment option for patients with Polycystic Ovary Syndrome: a meta-analysis of randomized controlled trials

Objectives: To date no consensus has been reached on whether to administer statin to patients with Polycystic Ovary Syndrome (PCOS) routinely. Therefore, we conduct a meta-analysis to synthesize the literatures regarding therapeutic effects of statins on PCOS.

Methods: A comprehensive literature search was performed using terms such as polycystic ovary syndrome, ovary polycystic disease, PCOS, hyperandrogaenemia; simvastatin, atorvastatin, lipidemic-modulating drugs, lipid lowering drugs, and testosterone; randomized controlled trials in the following bibliographic databases: Medline, Embase, Cochrane Controlled Trials Register. Identified reference lists were checked manually.

Results: In total, 4 RCTs were included. 3 of 4 studies were double-blinded while none reported whether of the data was analyzed using intention-to-treat analysis. Serum total testosterone and lipid profiles were included as investigation outcomes. Differences in reducing serum total testosterone were observed when comparing statin with placebo (Std MD= − 3.03, 95%CI − 5.85 ~ − 0.22, P=0.03) or statin + metformin with metformin (Std MD=− 1.07, 95%CI: − 2.06~ − 0.07, P=0.04). Heterogeneities were detected in both comparisons (I2=96% and 88% respectively). Meanwhile, statin was more effective than placebo in reducing LDL (WMD=− 0.87, 95%CI  − 1.18~ − 0.55, P<0.0001), TC (WMD=− 1.23 95%CI  − 1.35~ − 1.11, P<0.00001), TG (WMD= − 0.50, 95%CI  − 0.73~ − 0.27, P<0.00001); and statin + metformin was more effective than metformin in lowering LDL (WMD= − 0.84, 95%CI:  − 1.33 ~ − 0.354, P=0.0009), TC (WMD= − 1.28, 95%CI: − 1.47 ~ − 1.10, P<0.00001), and TG (WMD= − 0.27, 95%CI:  − 0.36~ − 0.19, P<0.00001). Heterogeneities were detected during the meta-analysis.

Conclusions: Statins can reduce the concentration of total testosterone, TC, TG and LDL. However, it cannot be concluded that statins have long-term benefit. A large-scale, randomized controlled study is needed to ascertain this uncertainty.