The Effects of Myo-Inositol and D-Chiro-Inositol in a Ratio 40:1 on Hormonal and Metabolic Profile in Women with Polycystic Ovary Syndrome Classified as Phenotype A by the Rotterdam Criteria and EMS-Type 1 by the EGOI Criteria.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Gynecologic and Obstetric Investigation Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI:10.1159/000536163
Olga Pustotina, Samuel H Myers, Vittorio Unfer, Irina Rasulova
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Abstract

Setting: Insulin resistance (IR) and compensatory hyperinsulinemia are considered contributing factors toward polycystic ovary syndrome (PCOS).

Objectives: This study evaluates the frequency of metabolic abnormalities in PCOS patients and the effects of myo-inositol (MI) and D-chiro-inositol (DCI), in a 40:1 ratio on hormonal and metabolic parameters.

Participants: Thirty-four women with PCOS phenotype A (endocrine-metabolic syndrome [EMS-type 1]) between the ages of 20-40.

Design: Open prospective study with phenotype A (EMS-type I, n = 34) supplemented with 2,255 mg/day of inositol (MI and DCI in a 40:1 ratio) for 3 months.

Methods: The following were measured before and after treatment: serum levels of follicular stimulating hormone, luteinizing hormone (LH), estradiol, total and free testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), anti-Müllerian hormone, glucose, insulin, HOMA-IR, and body mass index (BMI).

Results: 55.9% of the enrolled patients were overweight or obese, 50% affected by IR, 17.6% with a history of gestational diabetes mellitus, and 61.8% had familial diabetes mellitus. At the conclusion of the study, BMI (p = 0.0029), HOMA-IR (p < 0.001) significantly decreased, along with decreased numbers of patients with elevated insulin levels. The supplementation resulted in decreased total testosterone (p < 0.001), free testosterone (p < 0.001), FAI (p < 0.001), and LH (p < 0.001); increased SHBG (p < 0.001) and estradiol (p < 0.001).

Limitations: The present analysis was limited to a 12-week follow-up, which precluded a long-term evaluation of the effects of MI and DCI combination. Also, this period was insufficient to achieve and analyze clinical changes such as restoration of the menstrual cycle, restoration of reproductive function, and clinical manifestations of hyperandrogenism.

Conclusions: Supplementation improved metabolic and hormonal profile in PCOS phenotype A (EMS-type I) patients. This builds upon previous work that demonstrated that combined inositol treatment may be effective in PCOS. The study presented herein, used a reduced concentration than in prior literature; however, a significant change in hormonal and metabolic parameters was still observed.

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按照 40:1 的比例服用肌醇和 D-chiro- 肌醇对按照鹿特丹标准划分为 A 型多囊卵巢综合症和按照 EGOI 标准划分为 EMS-1 型多囊卵巢综合症女性荷尔蒙和新陈代谢状况的影响。
背景:胰岛素抵抗(IR)和代偿性高胰岛素血症被认为是导致多囊卵巢综合征(PCOS)的因素:本研究评估了多囊卵巢综合征患者代谢异常的频率,以及肌醇(MI)和D-螺肌醇(DCI)以40:1的比例对激素和代谢参数的影响:34名年龄在20-40岁之间的多囊卵巢综合征表型A(EMS-1型)女性:表型A(EMS类型I,n=34)补充2255毫克/天肌醇(MI和DCI的比例为40:1),为期3个月:测量治疗前后的下列指标:血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇、总睾酮和游离睾酮、性激素结合球蛋白(SHBG)、游离雄激素指数(FAI)、抗穆勒氏管激素(AMH)、血糖、胰岛素、HOMA-IR和体重指数(BMI):55.9%的患者超重或肥胖,50%的患者受IR影响,17.6%的患者有妊娠糖尿病史,61.8%的患者有家族糖尿病史。研究结束时,BMI(p=0.0029)、HOMA-IR(p局限性:本分析仅限于 12 周的随访,因此无法对 MI 和 DCI 联合治疗的效果进行长期评估。此外,这段时间也不足以实现和分析临床变化,如月经周期的恢复、生殖功能的恢复以及高雄激素的临床表现。结论 补充营养改善了多囊卵巢综合症表型 A(EMS I 型)患者的代谢和激素状况。此前的研究表明,肌醇联合治疗对多囊卵巢综合症有效。与之前的文献相比,本研究中使用的肌醇浓度较低,但仍观察到激素和代谢参数发生了显著变化。
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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