Myoinositol combined with alpha-lipoic acid may improve the clinical and endocrine features of polycystic ovary syndrome through an insulin-independent action

Abstract

The aim of our study was to investigate the effects of a combined treatment with alpha-lipoic acid (ALA) and myoinositol (MYO) on clinical, endocrine and metabolic features of women affected by polycystic ovary syndrome (PCOS). In this pilot cohort study, forty women with PCOS were enrolled and clinical, hormonal and metabolic parameters were evaluated before and after a six-months combined treatment with ALA and MYO daily. Studied patients experienced a significant increase in the number of cycles in six months (p < 0.01). The free androgen index (FAI), the mean androstenedione and DHEAS levels significantly decreased after treatment (p < 0.05). Mean SHBG levels significantly raised (p < 0.01). A significant improvement in mean Ferriman-Gallwey (F-G) score (p < 0.01) and a significant reduction of BMI (p < 0.01) were also observed. A significant reduction of AMH levels, ovarian volume and total antral follicular count were observed in our studied women (p< 0.05). No significant changes occurred in gluco-insulinaemic and lipid parameters after treatment. The combined treatment of ALA and MYO is able to restore the menstrual pattern and to improve the hormonal milieu of PCOS women, even in the absence of apparent changes in insulin metabolism.

MiRNAs Regulating Insulin Sensitivity Are Dysregulated in Polycystic Ovary Syndrome (PCOS) Ovaries and Are Associated With Markers of Inflammation and Insulin Sensitivity

“…Although insulin resistance (IR) is not considered as a diagnostic criterion, it underpins the disease in 50-70% of women independent of Body Mass Index (BMI) (2). Furthermore, insulin sensitizing treatments, as metformin, have often proved to be effective (3) and in recent years inositol derivatives (4,5) and alpha lipoic acid have shown positive effects besides being safe (6,7). The mechanisms related with the regulation of insulin sensitivity at the ovarian level are not fully elucidated yet.…”

The effect of myo‐inositol/di‐chiro‐inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: A systematic review and meta‐analysis

“…Two of the seven included studies were RCTs 16,24 and five were nonrandomized studies. 21,23,[28][29][30] All the studies were single-center studies with five of the seven studies conducted in Italy, one in Turkey and one in Georgia. In total, 415 women were recruited to these seven studies.…”

“…We have, however, included the study in our review as a consensus by international pediatric subspecialty societies states that a persistence of hyperandrogenic anovulation for ≥2 years distinguishes PCOS from physiologic anovulation. 31 Five of the included studies 21,23,24,28,29 assessed MI in varying doses ranging from 1 to 4 g daily and for varying durations between 12 weeks and 6 months with no explanations for variations in dose or duration of given treatment. Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC.…”

“…31 Five of the included studies 21,23,24,28,29 assessed MI in varying doses ranging from 1 to 4 g daily and for varying durations between 12 weeks and 6 months with no explanations for variations in dose or duration of given treatment. Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC. 21,28,29 Two of the studies 16,30 assessed the effects of DCI in doses ranging from 1000 to 1500 mg daily for durations from 180 days to 13 months.…”

“…Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC. 21,28,29 Two of the studies 16,30 assessed the effects of DCI in doses ranging from 1000 to 1500 mg daily for durations from 180 days to 13 months. One of these assessed the effect of DCI on serum AMH 30 and the other assessed its effect on AFC.…”