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 similar to-0.22, P = 0.03) or statin+metformin with metformin (Std MD = -1.07, 95%CI: -2.06 similar to-0.07, P = 0.04). Heterogeneities were detected in both comparisons (I-2 = 96% and 88% respectively). Meanwhile, statin was more effective than placebo in reducing LDL (WMD = -0.87, 95%CI -1.18 similar to-0.55, P < 0.0001), TC (WMD = -1.23 95%CI -1.35 similar to-1.11, P < 0.00001), TG (WMD = -0.50, 95%CI -0.73 similar to-0.27, P < 0.00001): and statin+metformin was more effective than metformin in lowering LDL (WMD = -0.84, 95%CI: -1.33 similar to-0.354, P = 0.0009), TC (WMD = -1.28, 95%CI: -1.47 similar to-1.10, P < 0.00001), and TG (WMD = -0.27, 95%CI: -0.36 similar to-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.