Short term effects of spironolactone on blood lipid profile: a 3‐month study on a cohort of young women with hirsutism

• Published in: British journal of clinical pharmacology Vol. 68; no. 4; pp. 634 - 637
• Main Authors: Nakhjavani, Manouchehr, Hamidi, Sepehr, Esteghamati, Alireza, Abbasi, Mehrshad, Nosratian‐Jahromi, Simindokht, Pasalar, Parvin
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2009; Blackwell; Blackwell Science Inc
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Cholesterol, HDL - blood; Cholesterol, HDL - metabolism; Cholesterol, LDL - blood; Cholesterol, LDL - metabolism; Female; Gynecology. Andrology. Obstetrics; HDL; hirsutism; Hirsutism - blood; Hirsutism - drug therapy; Humans; LDL; Lipids - blood; Medical sciences; Mineralocorticoid Receptor Antagonists - therapeutic use; PCOS; Pharmacology. Drug treatments; Polycystic Ovary Syndrome - drug therapy; Prospective Studies; Puberal and climacteric disorders (male and female); Short Reports; spironolactone; Spironolactone - adverse effects; Spironolactone - therapeutic use; Treatment Outcome; Young Adult; Endocrinopathy; Human; Short term; Hair; Biological fluid; Skin disease; Potassium sparing diuretic; Hirsutism; Lipids; Blood; Lipoprotein LDL; HDL; Aldosterone antagonist; Masculinization; PCOS; Spironolactone; LDL; Cohort study; Young adult; Lipoprotein HDL; Public health
• ISSN: 0306-5251; 1365-2125; 1365-2125
• DOI: 10.1111/j.1365-2125.2009.03483.x

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Spironolactone is known to have antiandrogenic features and agonist activity at progesterone receptors, which are responsible for several of its hormonal side‐effects. • The potential unfavourable influences of this medication on serum lipoproteins have long been a concern but literature lacks sufficient data on this issue. WHAT THIS STUDY ADDS • Spironolactone can adversely affect serum lipids by decreasing high‐density lipoprotein and increasing low‐density lipoprotein in women treated for hirsutism on a short‐term basis. AIMS To investigate the effects of spironolactone on serum lipids in women with hirsutism over a 3‐month period. METHODS In a prospective setting, 27 hirsute women (20 with polycystic ovary syndrome and seven with idiopathic hirsutism) with a mean age of 23.0 ± 5.1 years were studied at baseline and 3 months after receiving a daily dose of 100 mg of spironolactone. Patients did not receive any other medications and did not go through a specific diet during the study. Lipid profile, fasting blood glucose, testosterone, dehydroepiandrosterone sulphate (DHEAS) and prolactin (PRL) were measured at baseline and 3 months after therapy. RESULTS Mean body mass index of patients was 26.1 ± 5.1 kg m−2 before treatment and 25.9 ± 5.7 kg m−2 after treatment (NS). The therapy was associated with a significant decline of mean high‐density lipoprotein (HDL), 39.5 mg dl−1[95% confidence interval (CI) 35.6, 43.4]vs. 32.2 mg dl−1 (95% CI 29.2, 35.2), and a significant increase in mean low‐density lipoprotein (LDL), 133.1 mg dl−1 (95% CI 120.2, 146) vs. 150.8 mg dl−1 (95% CI 139.1, 162.5), and cholesterol/HDL ratio, 5 (95% CI 4.4, 5.6) vs. 6.4 (95% CI 5.7, 7.1) (P < 0.05). No significant change was noted in total cholesterol, triglyceride or fasting blood glucose levels. Serum values of testosterone, DHEAS and PRL decreased significantly after 3 months of therapy (P < 0.05). CONCLUSIONS Spironolactone might have adverse effects on serum lipoprotein levels by increasing LDL and decreasing HDL over a short course of treatment. While treating hirsutism with spironolactone, special care should be given to women with metabolic disorders such as dyslipidaemia.