Statins in the treatment of polycystic ovary syndrome.
Statins in the treatment of polycystic ovary syndrome.
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DOI：
10.1055/s-2007-992933
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发表时间：
2008
影响因子：
2.7
通讯作者：
P. Kodaman;A. Duleba
中科院分区：
文献类型：
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作者：
P. Kodaman;A. Duleba
多囊卵巢综合征（PCOS）是影响育龄妇女最常见的内分泌疾病。与该综合征相关的高雄激素血症是由于促性腺激素升高、高胰岛素血症和氧化应激等多种因素导致的膜间质组织过度生长和类固醇生成活性的结果。多囊卵巢综合征经常与其他心血管危险因素共存，如血脂异常和全身性炎症。他汀类药物抑制甲羟戊酸的合成，而甲羟戊酸是胆固醇生物合成的关键前体，可以降低心血管疾病的发病率和死亡率。阻断甲羟戊酸产生也可能导致胰岛素受体成熟程度降低，类固醇生成抑制（例如，通过限制底物：胆固醇的量），以及介导细胞增殖的信号转导途径的改变。后者依赖于蛋白质的翻译后修饰（戊酰化），这是一个由甲羟戊酸衍生物介导的过程。他汀类药物也具有内在的抗氧化特性。考虑到他汀类药物的多效性，它们不仅可能改善与多囊卵巢综合征相关的血脂异常，还可能发挥其他有益的代谢和内分泌作用。
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-aged women. The hyperandrogenemia associated with the syndrome is a result of excessive growth and steroidogenic activity of theca-interstitial tissues in response to various factors, including elevated gonadotropins, hyperinsulinemia, and oxidative stress. PCOS frequently coexists with other cardiovascular risk factors, such as dyslipidemia and systemic inflammation. Statins inhibit the synthesis of mevalonate, the key precursor to cholesterol biosynthesis, and reduce cardiovascular morbidity and mortality. Blockade of mevalonate production may also lead to decreased maturation of insulin receptors, inhibition of steroidogenesis (e.g., via limiting the amount of substrate: cholesterol), and alteration of signal transduction pathways that mediate cellular proliferation. The latter depend upon posttranslational modification of proteins (prenylation), a process mediated by mevalonate derivatives. Statins also have intrinsic antioxidant properties. Given the pleiotropic actions of statins, they are likely not only to improve the dyslipidemia associated with PCOS but may also exert other beneficial metabolic and endocrine effects.