A COMPARATIVE EVALUATION OF STATIN AND FENOFIBRATE (LIPID LOWERING DRUGS) ON THE INTERACTION OF PRO¬-INFLAMMATORY CYTOKINES AND VASOMOTOR INSTABILITY IN WOMEN WITH NATURALAND SURGICAL MENOPAUSE.

Abstract

Introduction:Evidence suggests that the decline in ovarian function with menopause is associated with spontaneous increase in proinammatory cytokines, especially IL-1, IL-6 and TNF-α. Objective:To evaluate the possible relationship of pro-inammatory cytokines and vasomotor symptoms in menopausal women on lipid lowering drugs- statin and fenobrate.Materials &Method: A prospective randomized clinical trial was carried out in the Dept. of Obstetrics and Gynaecology, I.P.G.M.E.R., Kolkata enrolling 100 women and dividing them into six groups. They were given either atorvastatin or fenobrate or no drug. The main outcome measures were to estimate changes in cytokine levels and vasomotor symptoms and their correlation. Results: Although the cytokine levels (except TGF-β) & incidence of vasomotor symptoms increased with menopause, there was only some positive correlation between TNF-α with increasing symptom at three month postoperative period. With atorvastatin therapy, moderate positive correlation (r >0.5) exists between decreasing levels of IL-1, IL-6 and TNF-α and decreasing vasomotor symptoms & strong negative correlation [r = -0.79] PB PB in case of TGF-β in natural menopausal women. In surgical menopausal women treated with atorvastatin correlation exists between TNF-α and TGF-β levels and vasomotor symptoms.There was no correlation found between any of the cytokine level and vasomotor symptom in women given fenobrate in natural menopausal group.but correlation found between TNF-α and TGF-β levels and vasomotor symptoms in the other group of subjects (for TNF-α r =+0.35 and for TGF-β r =−0.49 ). The levels of inammatory cytokines IL-1, IL-6, TNF-α increased within PB PB Conclusion: three months of surgical menopause while the level of anti-inammatory cytokine TGF-β decreased. Atorvastatin and fenobrate- both are effective in alleviating vasomotor symptoms, though statistically insignicant. The levels of inammatory cytokines, TNF-α and TGF-β are best correlated with vasomotor symptoms in menopausal women.