The effect of atorvastatin on cardiometabolic risk factors in women with non-classic congenital adrenal hyperplasia: A pilot study

Krysiak, Robert; Kowalcze, Karolina; Bednarska-Czerwińska, Anna

doi:10.1016/j.pharep.2019.01.014

Cited by 8 publications

(6 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the current study, testosterone and FAI were lower in hypoprolactinemic than in normoprolactinemic women, while atorvastatin administration to women with prolactin failure led to a further decrease in FAI. The inhibitory effect of statin on testosterone production was observed previously in women with polycystic ovary syndrome [23] and congenital adrenal hyperplasia [24]. This explanation is also in line with the findings of other research teams showing that reduced androgen levels in women may predispose to cardiovascular disease [25], while severe atherosclerosis in postmenopausal women inversely correlates with free testosterone levels [26].…”

Section: Discussionsupporting

confidence: 88%

Cabergoline-Induced Hypoprolactinemia May Attenuate Cardiometabolic Effects of Atorvastatin: A Pilot Study

Krysiak

Kowalcze

2022

Cardiology

Self Cite

View full text Add to dashboard Cite

Introduction: Hypoprolactinemia, which is usually a consequence of treatment with inadequate high doses of dopaminergic agents, is poorly understood clinical condition. The aim of the current study was to investigate whether cardiometabolic effects of statin therapy differ between patients with low prolactin production and patients with normal levels of this hormone. Methods: We studied two groups of cabergoline-treated premenopausal women with hypercholesterolemia matched for age, plasma lipids, cabergoline dose and treatment duration: 11 women with hypoprolactinemia (group A) and 15 women with plasma levels of this hormone within the reference range (group B). The control group (C) included 25 dopaminergic-naïve normoprolactinemic women, matched for age and lipid levels. Plasma lipids, insulin sensitivity and levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine and 25-hydroxyvitamin D were measured before and after 14-week treatment with atorvastatin (20 mg daily). Results: Patients with hypoprolactinemia were more insulin-resistant, had lower values of total testosterone and free androgen index, and had higher levels of hsCRP and fibrinogen than individuals with normal prolactin levels. Although atorvastatin reduced total and LDL-cholesterol and hsCRP in all study groups, this effect was stronger in groups B and C than in group A. Only in groups B and C, the drug decreased uric acid, fibrinogen and homocysteine, and increased 25-hydroxyvitamin D. In turn, only in group A, atorvastatin worsened insulin sensitivity and reduced free androgen index. Discussion/Conclusion: Coexisting hypoprolactinemia may have an unfavorable impact on pleiotropic effects of statins.

show abstract

Section: Discussionsupporting

confidence: 88%

Cabergoline-Induced Hypoprolactinemia May Attenuate Cardiometabolic Effects of Atorvastatin: A Pilot Study

Krysiak

Kowalcze

2022

Cardiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…This dimorphism in atorvastatin action was also observed in previous studies carried out by our research team. Although the drug was found to have a neutral effect on 25-hydroxyvitamin D levels in subjects with autoimmune thyroiditis [11,35], the treatment improved vitamin D status in women without endocrine abnormalities [36] or with non-classic congenital adrenal hyperplasia [37]. Statin-induced inhibition of HMG-CoA reductase may lead to an increase in 7-dehydrocholesterol, providing a substrate for the synthesis of 25-hydroxyvitamin D [38].…”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic Risk Factors in Atorvastatin-Treated Women with Euthyroid Autoimmune Thyroiditis

Krysiak

Kowalcze

2023

Pharmacology

Self Cite

View full text Add to dashboard Cite

Introduction: Autoimmune thyroiditis seems to be associated with increased cardiometabolic risk. Statins, the mainstay of cardiovascular risk reduction and prevention, were found to reduce thyroid antibody titers. The aim of this study was to investigate plasma markers of cardiometabolic risk in statin-treated women with thyroid autoimmunity. Methods: We compared two matched groups of euthyroid women with hypercholesterolemia receiving atorvastatin treatment: subjects with autoimmune (Hashimoto’s) thyroiditis (group A, n = 29) and subjects without thyroid pathology (group B, n = 29). Plasma lipids, glucose homeostasis markers, as well as circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and 25-hydroxyvitamin D were measured before atorvastatin treatment and 6 months later. Results: At entry, both groups differed in antibody titers, insulin sensitivity, and plasma levels of uric acid, hsCRP, fibrinogen, homocysteine, and 25-hydroxyvitamin D. Atorvastatin-induced reduction in hsCRP and homocysteine, but not in total cholesterol and LDL-cholesterol, was more pronounced in group B than in group A. Only in group B, the drug decreased uric acid and fibrinogen and increased 25-hydroxyvitamin D. In group A, atorvastatin reduced insulin responsiveness. Conclusion: The obtained results indicate that euthyroid women with Hashimoto’s thyroiditis may benefit to a lesser degree from atorvastatin treatment than other populations of women with hypercholesterolemia.

show abstract

“…Krysiak et al. ( 139 ) reported that atorvastatin, a statin that reduced the levels of cholesterol and androgens, decreased the cardiometabolic risk in untreated NCCAH women. If this decrease in risk also leads to fewer cardiovascular incidents in these patients, needs to be further elucidated.…”

Section: Cardiovascular and Metabolic Complicationsmentioning

confidence: 99%

Challenges in treatment of patients with non-classic congenital adrenal hyperplasia

Adriaansen¹,

Schröder²,

Span

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

Congenital adrenal hyperplasia (CAH) due to 21α-hydroxylase deficiency (21OHD) or 11β-hydroxylase deficiency (11OHD) are congenital conditions with affected adrenal steroidogenesis. Patients with classic 21OHD and 11OHD have a (nearly) complete enzyme deficiency resulting in impaired cortisol synthesis. Elevated precursor steroids are shunted into the unaffected adrenal androgen synthesis pathway leading to elevated adrenal androgen concentrations in these patients. Classic patients are treated with glucocorticoid substitution to compensate for the low cortisol levels and to decrease elevated adrenal androgens levels via negative feedback on the pituitary gland. On the contrary, non-classic CAH (NCCAH) patients have more residual enzymatic activity and do generally not suffer from clinically relevant glucocorticoid deficiency. However, these patients may develop symptoms due to elevated adrenal androgen levels, which are most often less elevated compared to classic patients. Although glucocorticoid treatment can lower adrenal androgen production, the supraphysiological dosages also may have a negative impact on the cardiovascular system and bone health. Therefore, the benefit of glucocorticoid treatment is questionable. An individualized treatment plan is desirable as patients can present with various symptoms or may be asymptomatic. In this review, we discuss the advantages and disadvantages of different treatment options used in patients with NCCAH due to 21OHD and 11OHD.

show abstract

The effect of atorvastatin on cardiometabolic risk factors in women with non-classic congenital adrenal hyperplasia: A pilot study

Cited by 8 publications

References 38 publications

Cabergoline-Induced Hypoprolactinemia May Attenuate Cardiometabolic Effects of Atorvastatin: A Pilot Study

Cabergoline-Induced Hypoprolactinemia May Attenuate Cardiometabolic Effects of Atorvastatin: A Pilot Study

Cardiometabolic Risk Factors in Atorvastatin-Treated Women with Euthyroid Autoimmune Thyroiditis

Challenges in treatment of patients with non-classic congenital adrenal hyperplasia

Contact Info

Product

Resources

About