Comparative effects of atorvastatin and simvastatin on the plasma total homocysteine levels in women with polycystic ovary syndrome: a prospective randomized study

Objective: To test the hypothesis that statins improve hyperhomocysteinemia in women with polycystic ovary syndrome (PCOS). Design: A prospective randomized study. Setting: University Hospital. Patient(s): Fifty-two women with PCOS and 52 women matched for age and body mass index as controls. Intervention(s): Patients were randomly divided into two groups for treatment: group 1, atorvastatin, 20 mg daily (n = 26), and group 2, simvastatin, 20 mg daily (n = 26). Blood samples were obtained before and after treatment. Main Outcome Measure(s): Serum homocysteine levels. Result(s): After 12 weeks of treatment, serum homocysteine levels in group 1 had decreased from 14.3 +/- 2.9 to 10.6 +/- 1.7 mu mol/L; in group 2, the levels decreased from 13.6 +/- 2.1 to 11.1 +/- 1.9 mu mol/L. Both two groups, free testosterone and total testosterone declined statistically significantly (38.3% and 36.5%; and 40.6% and 46.0%, respectively). In group 1, vitamin B-12 increased from 362.1 +/- 107 to 478.7 +/- 267 pg/mL; in group 2, it increased from 391.3 +/- 107 to 466 +/- 211 pg/mL, but the change did not reach statistical significance. There was a considerable decline in the homeostatic model assessment index in group 1 (40.0% to 32.1%). Conclusion(s): Treatment with statins in women with PCOS leads to decreases in serum homocysteine levels. (Fertil Steril (R) 2009;92:635-42. (C)2009 by American Society for Reproductive Medicine.)