The Effect of Simvastatin Treatment on Plasma Steroid Levels in Females with Non-classic Congenital Adrenal Hyperplasia

Abstract

Non-classic congenital adrenal hyperplasia (NC-CAH) is one of the most frequent genetic disorders and its presence often results in androgen excess. 4 females with coexisting symptomatic NC-CAH and isolated hypercholesterolemia and 11 sex- and weight-matched control subjects with elevated cholesterol but normal steroid levels, participating in our study, were treated with simvastatin (20 mg daily). Throughout the whole period of simvastatin treatment, plasma levels of 17-hydroxyprogesterone, testosterone, androstendione and dehydroepiandrosterone sulfate in patients with NC-CAH remained lower compared with baseline, but increased in 2 patients after withdrawal of this drug. No changes in plasma steroids were observed in simvastatin-treated control subjects. Our findings suggest that simvastatin treatment may bring some benefits to symptomatic female patients with NC-CAH.

Key words

adrenal cortex - congenital adrenal ­hyperplasia - androgens - statins

• References

• 1 Speiser PW. Nonclassic adrenal hyperplasia. Rev Endocr Metab Disord 2009; 10: 77-82
• 2 Moran C, Azziz R. 21-hydroxylase-deficient nonclassic adrenal hyperplasia: the great pretender. Semin Reprod Med 2003; 21: 295-300
• 3 Banaszewska B, Pawelczyk L, Spaczynski RZ et al. Effects of simvastatin and oral contraceptive agent on polycystic ovary syndrome: prospective, randomized, crossover trial. J Clin Endocrinol Metab 2007; 92: 456-461
• 4 Banaszewska B, Pawelczyk L, Spaczynski RZ et al. Effects of simvastatin and metformin on polycystic ovary syndrome after six months of treatment. J Clin Endocrinol Metab 2011; 96: 3493-3501
• 5 Sathyapalan T, Kilpatrick ES, Coady AM et al. The effect of atorvastatin in patients with polycystic ovary syndrome: a randomized double-blind placebo-controlled study. J Clin Endocrinol Metab 2009; 94: 103-108
• 6 Raja-Khan N, Kunselman AR, Hogeman CS et al. Effects of atorvastatin on vascular function, inflammation, and androgens in women with polycystic ovary syndrome: a double-blind, randomized, placebo-controlled trial. Fertil Steril 2011; 95: 1849-1852
• 7 Jasinska M, Owczarek J, Orszulak-Michalak D. Statins: a new insight into their mechanisms of action and consequent pleiotropic effects. Pharmacol Rep 2007; 59: 483-499
• 8 Rzepczynska IJ, Piotrowski PC, Wong DH et al. Role of isoprenylation in simvastatin-induced inhibition of ovarian theca-interstitial growth in the rat. Biol Reprod 2009; 81: 850-855