The Effects of Statins on Hyperandrogenism In Women With Polycystic Ovary Syndrome: A Systematic Review And Meta-analysis of Randomized Controlled Trials

Abstract Several clinical studies showed that statins were potential to treat polycystic ovary syndrome (PCOS). Through comprehensive search PubMed, EMBASE, the Web of Science, BIOSIS, the ClinialTrails.gov, and the Cochrane Library database up to 14 Feb 2020, we identified the randomized controlled trials about the treatment of statins on hyperandrogenism in PCOS women, and performed a systematic review and meta-analysis. The quality of the included studies was assessed by the Cochrane risk of bias tool and the Jadda score. Subgroup analysis and sensitivity analysis were conducted to analyze the pooled results. Nine trials included 682 PCOS patients were identified. Statins showed a significant potential to reduce testosterone (SMD=-0.47; 95% CI, -0.76−-0.18; P = 0.002) and dehydroepiandrosterone (SMD=-0.51; 95% CI, -0.97−-0.05; P = 0.03) levels, compared to the control treatments. The cutaneous symptoms hirsutism (SMD=-0.61; 95% CI, -1.13−-0.10; P = 0.02) and acne (SMD=-0.92; 95% CI, -1.49−-0.34; P = 0.002) were significantly improved by statins in PCOS women. Subgroup analysis showed that the two types of statins, and the different control treatments as well, presented no significantly different effect on testosterone and dehydroepiandrosterone. Sensitivity analysis confirmed the stability of the findings from the meta-analysis. In conclusion, statin treatment could significantly reduce androgen levels and improve cutaneous manifestations of hyperandrogenism of PCOS.