The Ratio of MI to DCI and Its Impact in the Treatment of Polycystic Ovary Syndrome: Experimental and Literature Evidences

Introduction. We evaluated the effects of a therapy that combines myo-inositol (MI) and D-chiro-inositol (DCI) in young overweight women affected by polycystic ovary syndrome (PCOS), characterized by oligo- or anovulation and hyperandrogenism, correlated to insulin resistance. Methods. We enrolled 46 patients affected by PCOS and, randomly, we assigned them to two groups, A and B, treated, respectively, with the association of MI plus DCI, in a 40 : 1 ratio, or with placebo (folic acid) for six months. Thus, we analyzed pretreatment and posttreatment FSH, LH, 17-beta-Estradiol, Sex Hormone Binding Globulin, androstenedione, free testosterone, dehydroepiandrosterone sulphate, HOMA index, and fasting glucose and insulin. Results. We recorded a statistically significant reduction of LH, free testosterone, fasting insulin, and HOMA index only in the group treated with the combined therapy of MI plus DCI; in the same patients, we observed a statistically significant increase of 17-beta-Estradiol levels. Conclusions. The combined therapy of MI plus DCI is effective in improving endocrine and metabolic parameters in young obese PCOS affected women.

Section: Introductionmentioning

confidence: 99%

A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women

Benelli

Ghianda

Cosmo

et al. 2016

“…Myo-Ins, through its insulin-sensitizing effect, plays an important role in improving metabolic and hormonal parameters in women affected with PCOS [ 114 , 115 ]. However, the best therapy for this disorder is constituted by the treatment with myo-Ins plus D-chiro-Ins combined in agreement with the physiological myo-Ins/D-chiro-Ins plasma ratio (40 : 1) [ 116 – 119 ], which allows obtaining very interesting results and also avoids some detrimental effects due to D-chiro-Ins alone at high concentrations [ 120 ]. Myo-Ins involvement in the reproductive axis function is highlighted by the pivotal role played by inositol (1,4,5)-triphosphate [Ins(1,4,5)P3] in the regulation of calcium ion (Ca 2+ ) release during oocytes development and its role in meiotic competence and the final stage of oocyte maturation [ 121 ].…”

Section: Insulin-sensitizers In Pcos and Cancer Preventionmentioning

confidence: 99%

Insulin-Sensitizers, Polycystic Ovary Syndrome and Gynaecological Cancer Risk

Lauretta¹,

Lanzolla

Vici³

et al. 2016

Preclinical, early phase clinical trials and epidemiological evidence support the potential role of insulin-sensitizers in cancer prevention and treatment. Insulin-sensitizers improve the metabolic and hormonal profile in PCOS patients and may also act as anticancer agents, especially in cancers associated with hyperinsulinemia and oestrogen dependent cancers. Several lines of evidence support the protection against cancer exerted by dietary inositol, in particular inositol hexaphosphate. Metformin, thiazolidinediones, and myoinositol postreceptor signaling may exhibit direct inhibitory effects on cancer cell growth. AMPK, the main molecular target of metformin, is emerging as a target for cancer prevention and treatment. PCOS may be correlated to an increased risk for developing ovarian and endometrial cancer (up to threefold). Several studies have demonstrated an increase in mortality rate from ovarian cancer among overweight/obese PCOS women compared with normal weight women. Long-term use of metformin has been associated with lower rates of ovarian cancer. Considering the evidence supporting a higher risk of gynaecological cancer in PCOS women, we discuss the potential use of insulin-sensitizers as a potential tool for chemoprevention, hypothesizing a possible rationale through which insulin-sensitizers may inhibit tumourigenesis.

“…Together with its isomer D-chiro-inositol (D-chiro-Ins), myo-Ins acts as second messenger of insulin [ 9 ] and has been widely studied for its involvement in metabolic syndrome (reviewed by [ 10 ]) as well as for the treatment of polycystic ovary syndrome (PCOS) (reviewed by [ 11 , 12 ]), one of the most common female endocrine disorders [ 13 ] strictly associated with insulin resistance [ 14 ]. Recent reports strongly suggest that both Ins isomers can be positively associated in the management of PCOS patients enrolled in assisted reproduction procedures [ 15 ], with significant encouraging clinical outcomes [ 16 ].…”

Section: Myo-inositol In Reproduction Gametogenesis and Embryonimentioning

confidence: 99%

Myo-Inositol Safety in Pregnancy: From Preimplantation Development to Newborn Animals

Kuşçu

Bizzarri

Bevilacqua

2016

Myo-inositol (myo-Ins) has a physiological role in mammalian gametogenesis and embryonic development and a positive clinical impact on human medically assisted reproduction. We have previously shown that mouse embryo exposure to myo-Ins through preimplantation development in vitro increases proliferation activity and blastocyst production, representing an improvement in culture conditions. We have herein investigated biochemical mechanisms elicited by myo-Ins in preimplantation embryos and evaluated myo-Ins effects on postimplantation/postnatal development. To this end naturally fertilized embryos were cultured in vitro to blastocyst in the presence or absence of myo-Ins and analyzed for activation of the PKB/Akt pathway, known to modulate proliferation/survival cellular processes. In parallel, blastocyst-stage embryos were transferred into pseudopregnant females and allowed to develop to term and until weaning. Results obtained provide evidence that myo-Ins induces cellular pathways involving Akt and show that (a) exposure of preimplantation embryos to myo-Ins increases the number of blastocysts available for uterine transfer and of delivered animals and (b) the developmental patterns of mice obtained from embryos cultured in the presence or absence of myo-Ins, up to three weeks of age, overlap. These data further identify myo-Ins as a possibly important supplement for human preimplantation embryo culture in assisted reproduction technology.