Abstract
Non-classic congenital adrenal hyperplasia (NC-CAH), one of the most common genetic
disorders, is often associated with the presence of hyperandrogenism. Recently both
simvastatin and metformin were found to reduce plasma steroid hormone levels in this
disorder. This study included 8 women with NC-CAH and diabetes or impaired glucose
tolerance, as well as 12 matched women with similar glucose metabolism abnormalities
but normal adrenal function. Both groups of women, receiving metformin for at least
6 months, were then treated with simvastatin (20 mg daily) for the following 12 weeks.
Compared to patients with normal adrenal function, metformin-treated women with NC-CAH
showed increased plasma levels of 17-hydroxyprogesterone, total testosterone, free
testosterone, androstenedione and DHEA-S. Simvastatin reduced total and LDL cholesterol
levels in both patients with NC-CAH and normal adrenal function. Moreover, in the
former group of women, statin therapy decreased plasma levels of testosterone, free
testosterone, androstenedione, dehydroepiandrosterone sulphate and tended to reduce
17-hydroxyprogesterone. Our results suggest that metformin-statin combination therapy
may be useful in the management of symptomatic women with NC-CAH.
Key words
congenital adrenal hyperplasia - metformin - statins - steroid hormones
