A study of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS

Abstract

Background: Polycystic ovarian syndrome (PCOS) is characterized by the combination of hyperandrogenism, chronic anovulation and polycystic ovaries. Objective of present study was to compare the effects of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS.Methods: 66 women were randomly assigned into three equal treatment groups. Group 1 received N-acetyl cysteine, 600 mg three times a day. Group 2 metformin hydrochloride, 500 mg two times a day for 1 week, then three times a day for rest of the study and Group 3 Vit-D3 60,000 IU weekly with calcium 1500mg daily. Clinical and metabolic assessment was done at baseline and after three months of treatment.Results: After 12 weeks of treatment improvement of symptoms was seen in all the three groups, however better improvement in oligomenorrhea and hirsutism was seen in metformin group than others two groups. The clinical parameters like weight, BMI, waist hip ratio, biochemical markers of insulin resistance, fasting glucose, fasting insulin, fasting glucose/insulin ratio were significantly decreased in N-acetyl cysteine group than others two groups.Conclusions: N-acetyl cysteine had better improvement in clinical, and metabolic profile than metformin and vitamin D3 with Calcium group in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.

Retracted: Randomized controlled trial of N‐acetylcysteine versus l‐carnitine among women with clomiphene‐citrate‐resistant polycystic ovary syndrome

“…Regarding its insulin-sensitizing effects, N-acetylcysteine has been found to decrease FG, FI, and the FG/FI ratio after 3 months of treatment, 14 consistent with the present study. In another study, the effects of N-acetylcysteine on FG, FI, FG/FI, and HOMA index were better or equal to those of metformin.…”

“…To our knowledge, the present study is the first to compare the reproductive and metabolic effects of N ‐acetylcysteine and l ‐carnitine therapy for women with PCOS. Neither of the drugs reduced BMI, although previous trials reported a significant reduction in BMI after both N ‐acetylcysteine and l ‐carnitine therapy. Variations in pretreatment BMI, drug doses, associated lifestyle changes, and the study populations might explain these different effects on BMI.…”

The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis

“…Subgroup analyses based on follow-up time showed that longer duration of NAC intervention was associated with more effective changes in BMI, FBG and FI, and longer duration of NAC treatment was associated with better outcomes. This is consistent with the conclusions of the two included studies (28,29). PCOS is a common condition with important effects throughout the life cycle, including reproductive, metabolic, and psychological effects, so long-term interventions are important in PCOS management (39).…”

“…Overall, we included 11 RCTs involving 869 women with PCOS, published between 2009 and 2022 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Of these studies, the majority were conducted in Asia and only 1 was conducted in Africa (30), of which 5 were conducted in India (25,26,28,29,32), 4 in Iran (22,24,27,31), 1 in Egypt (30), and 1 in Turkey (23).…”

“…Overall, we included 11 RCTs involving 869 women with PCOS, published between 2009 and 2022 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Of these studies, the majority were conducted in Asia and only 1 was conducted in Africa (30), of which 5 were conducted in India (25,26,28,29,32), 4 in Iran (22,24,27,31), 1 in Egypt (30), and 1 in Turkey (23). Most studies had a control group medication of metformin, one had a placebo (oral rehydration salts) (22), and one was a three arm study with a control group medication of placebo and metformin (24).…”