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Statins, Oxidative Stress, and Polycystic Ovary Syndrome

  • Chapter
Insulin Resistance and Polycystic Ovarian Syndrome

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Polycystic ovary syndrome (PCOS) is typically characterized by hyperandrogenism, menstrual dysfunction, and altered ovarian morphology. Typically, women with PCOS also have a broad range of metabolic changes including hyperinsulinemia, increased oxidative stress, systemic inflammation, dyslipidemia, and elevation of several growth factors and cytokines. Oxidative stress, proinflammatory cytokines, and hyperinsulinemia may significantly contribute to excessive growth of the ovarian theca-interstitial compartment and to increased production of androgens.

It has become apparent that statins not only improve lipid profile, but may also have anti-inflammatory and antioxidant effects. Furthermore, statins may modify important signal transduction pathways involved in the regulation of cell proliferation. In vitro studies have demonstrated that statins inhibit growth and steroidogenesis of ovarian theca-interstitial cells. In these cells, statins may also limit oxidative stress by decreasing expression of subunits of NADPH oxidase.

A recent randomized prospective clinical trial evaluated the effects of simvastatin on women with PCOS. Simvastatin treatment reduced serum testosterone, normalized gonadotropins, and improved lipid profile.

In summary, inhibition of the mevalonate pathway by statins profoundly affects function and growth of ovarian mesenchyme and may result in both improved ovarian function and systemic cardiovascular benefits in women with PCOS.

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Authors and Affiliations

  1. Department of Obstetrics/Gynecology, Yale University School of Medicine, New Haven, CT

    Pinar H. Kodaman MD, PhD & Antoni J. Duleba MD

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  1. Pinar H. Kodaman MD, PhD
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Editors and Affiliations

  1. Endocrine Section of First Department of Internal Medicine, Athens University School of Medicine, Athens, Greece

    Evanthia Diamanti-Kandarakis MD, PhD

  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA

    John E. Nestler MD

  3. Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Dimitrios Panidis MD, PhD

  4. Endocrinology Unit, Department of Internal Medicine and Gastroenterology and C.R.B.A., S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Renato Pasquali MD

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Kodaman, P.H., Duleba, A.J. (2007). Statins, Oxidative Stress, and Polycystic Ovary Syndrome. In: Diamanti-Kandarakis, E., Nestler, J.E., Panidis, D., Pasquali, R. (eds) Insulin Resistance and Polycystic Ovarian Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-310-3_19

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