The impact of atorvastatin on cardiometabolic risk factors in brothers of women with polycystic ovary syndrome

Abstract

Background Women with polycystic ovary syndrome (PCOS) are characterized by increased cardiometabolic risk. The aim of the current study was to compare the impact of atorvastatin on plasma levels of cardiometabolic risk factors between men whose sisters had either PCOS or were unaffected. Methods The study population consisted of two age-, fat-free mass index-, blood pressure- and plasma lipid-matched groups of men with elevated total and LDL cholesterol levels: 20 brothers of PCOS probands (group 1) and 20 brothers of healthy women (group 2). Both groups were then treated with atorvastatin (40 mg daily) for the following 6 months. At the beginning and at the end of the study, we assessed plasma lipid levels, glucose homeostasis markers and levels of dehydroepiandrosterone sulfate, testosterone, bioavailable testosterone, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen and 25-hydroxyvitamin D. Results At the beginning of the study, both treatment arms differed in the degree of insulin resistance, calculated bioavailable testosterone, as well as in plasma levels of dehydroepiandrosterone sulfate, uric acid, hsCRP and 25-hydroxyvitamin D. Although atorvastatin reduced total and LDL cholesterol levels, this effect was stronger in group 2 than group 1. In group 2, atorvastatin exerted also a more potent impact on hsCRP, fibrinogen and homocysteine. An unfavorable impact on insulin sensitivity was observed only in group 1; while, statistically significant changes in uric acid and 25-hydroxyvitamin D levels were found only in group 2. Conclusion The obtained results suggest that cardiometabolic effects of atorvastatin are less pronounced in male siblings of PCOS probands than in brothers of unaffected women.

The Impact of Telmisartan on Cardiometabolic Risk Factors in Hypertensive Male Siblings of Women With Polycystic Ovary Syndrome

“…In line with a previous study including normotensive men with elevated total and LDL cholesterol, 17 at the beginning of the study brothers of PCOS probands differed from male siblings of unaffected women in the severity of insulin resistance, plasma levels of androstenedione, and calculated bioavailable testosterone, as well as in levels of hsCRP and 25‐hydroxyvitamin D. Male siblings of women with PCOS were also characterized by a more atherogenic lipid profile. Our findings cannot be attributed to anthropometric differences and/or various blood pressure values because both study groups were matched for age, total and fat‐free mass index, and blood pressure.…”

“…Bioavailable testosterone is regarded as a better marker of androgen status in men than total testosterone and its precursor, 28 and therefore, despite no significant impact of telmisartan on total testosterone and androstenedione, this finding seems relevant. Previously, we reported that lower calculated bioavailable testosterone in brothers of women with PCOS was accompanied by increased dehydroepiandrosterone sulfate 17 . This observation indicates that male siblings of PCOS probands may be characterized by impaired conversion of dehydroepiandrosterone sulfate to testosterone.…”

“…Telmisartan is a drug with a number of pharmacological properties that distinguish it from other angiotensin II receptor blockers (the longest plasma half‐life, highest lipophilicity, and strongest receptor‐binding affinity in class), and its cardiovascular benefits cannot be explained only by blood pressure‐lowering properties 16 . However, the recent finding that pleiotropic effects of atorvastatin in male siblings of PCOS probands were weakly pronounced 17 raises doubts about the effectiveness of cardiovascular drugs in these patients. Therefore, the aim of the current study was to compare hypotensive and cardiometabolic effects of telmisartan between male siblings of PCOS women and unrelated men with hypertension.…”

Cardiometabolic Risk Factors in Rosuvastatin-Treated Men with Mixed Dyslipidemia and Early-Onset Androgenic Alopecia

“…Because of the exclusion criteria and selection procedure, these findings could not be attributed to differences in body mass index, blood pressure, plasma lipids, concomitant disorders, or drug interactions. The hormonal profile of individuals with early-onset alopecia differed from that observed in the male siblings of PCOS probands, in whom elevated concentrations of DHEA-S coexisted with lower levels of calculated bioavailable testosterone [ 17 ]. Unlike bioavailable testosterone, in both studies, mean total testosterone levels were similar to those observed in control groups.…”

“…The results of a recent study indicated that cardiometabolic effects of atorvastatin are less pronounced in brothers of women with polycystic ovary syndrome than in the male siblings of unaffected women [ 17 ]. Moreover, high-dose treatment with rosuvastatin, the latest and the most potent statin that is currently available on the market and frequently used in clinical practice, was found to reduce circulating testosterone levels but not to affect levels of DHEA-S in men with coronary artery disease [ 18 ].…”