The Pluripotential Effects of Hypolipidemic Treatment for Polycystic Ovary Syndrome (PCOS): Dyslipidemia, Cardiovascular Risk Factors and Beyond

Frangiskos      Economou; Xenofon      Xyrafis; Charikleia      Christakou; Evanthia      Diamanti-Kandarakis

Abstract

Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome characterized by oligo- or anovulation, clinical and/or biochemical signs of hyperandrogenemia and polycystic ovaries. Clinical expression is determined by both genetic and environmental factors. Dyslipidemia is very common in lean as well as in obese women with PCOS and should be considered in the therapeutic management of the syndrome. Additionally to dyslipidemia, other risk factors for cardiovascular disease strongly associated with PCOS include insulin resistance, impaired glucose tolerance and metabolic syndrome. Therefore, the ideal therapeutic approach for PCOS would be multi targeted treatment ameliorating not only ovarian dysfunction but also cardiometabolic aspects, including dyslipidemia. Recently, a new era of hypolipidemic agents like statins has been initiated with regard to PCOS. The spectrum of statins targets has been expanded and in vitro and in vivo studies have explored the specific effect of statins on androgen production, insulin resistance and inflammatory markers in PCOS. Statins are potentially promising therapeutic agents targeting hormonal and metabolic disturbances in PCOS, though conclusive results are still pending. Since several hormonal and metabolic aberrations characterizing this multifaceted syndrome cluster and interact with each other, their effects on the lipid profile are interweaving and the therapeutic modalities targeting dyslipidemia appear to have a more broad beneficial effect.

Keywords: Polycystic ovary syndrome, dyslipidemia, statins, antiandrogens, insulin sensitizers, anovulation, hyperandrogenemia, insulin, obesity, nosological, oligoovulation, ultrasonography, steroidogenic, phosphorylation, dihydrotestosterone, flutamide, hyperinsulinemia, fibrinogen, hirsutism, angiographic