Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients

Abstract

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, chronic anovulation, polycystic ovaries at ultrasound evaluation, and quite frequently by insulin resistance or compensatory hyperinsulinemia. Attention has been given to the role of inositol-phosphoglycan (IPG) mediators of insulin action and growing evidences suggest that a deficiency of D-chiro-inositol (DCI) containing IPG might be at the basis of insulin resistance, frequent in PCOS patients. On such basis, we investigated the efficacy on insulin sensitivity and hormonal parameters of 8 weeks treatment with myo-inositol (MYO) (Inofert, ItalPharmaco, Milano, Italy) at the dosage of 2 g day in a group (n = 42) of obese PCOS patients,. After the treatment interval body mass index (BMI) and insulin resistance decreased together with luteinizing hormone (LH), LH/FSH and insulin. When subdividing the patients according to their fasting insulin levels, Group A (n = 15) insulin below 12 µU/ml and Group B (n = 27) insulin above 12 µU/ml, MYO treatment induced similar changes in both groups but only patients of Group B showed the significant decrease of both fasting insulin plasma levels (from 20.3 ± 1.8 to 12.9 ± 1.8 µU/ml, p < 0.00001) and of area under the curve (AUC) of insulin under oral glucose tolerance test (OGTT). In conclusion, our study supports the hypothesis that MYO administration is more effective in obese patients with high fasting insulin plasma levels.

Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with d-Chiro-Inositol

“…Phosphoglycans formed by DChiro-Inositol seem to play a relevant role in insulin signaling transduction and seems to be more effective in partially restoring insulin sensitivity and glycogen synthesis than phosphoglycan incorporating Myo-Inositol [25]. Accumulating evidence suggests that Myo-Inositol could play a key role in improving hormonal and metabolic homeostasis in PCOS [26][27][28][29][30][31], assisted reproductive technology (ART) [32][33][34][35], and even in Gestational Diabetes Mellitus (GDM) [36][37][38][39]. Nevertheless, in PCOS patients, Myo-Inositol seems to have the most marked effect on the metabolic profile, whereas D-Chiro-Inositol reduces hyperandrogenism better [40].…”

Study of effect of myoinositol on menstrual irregularities and skin problems in polycystic ovarian syndrome cases

“…16,[19][20][21] Minozzi et al found significant reduction from 9.7+3.6 to 6.7±1.9 (p<0.05) in Ferriman Gallwey score after 12 months therapy with 4gm Myoinositol plus 400µg folic acid in combination with OCP (EE 30 µg/gestodene 75 mg) and also shown significant reduction from 10.2+3.4 to 8.1+2.3 in group receiving OCP (EE 30 µg/gestodene 75 mg) alone but FG score was significantly lower in OCP+MYO+Folic acid group compared with OCP group (p<0.001). 19 Zacche et al found significant reduction from 11.4±3.2 to 9.94±2.8 in Ferriman Gallwey score after 6 months therapy with 2gm Myoinositol (p<0.05) and Le donne et al also observed significant reduction in Ferriman Gallwey score after 12 wks therapy with 4gm Myoinositol+Diet+metformin (p<0.05).…”

Improvement in quality of oocytes in polycystic ovarian syndrome in programs of in vitro fertilization

“…Genazzani et al [15] report an increase in the body mass index in patients with PCOS. These data were not confirmed in our study, the body mass index values in the groups were comparable.…”