A comparative study of combination of Myo-inositol and D-chiro-inositol versus Metformin in the management of polycystic ovary syndrome in obese women with infertility

Thalamati, Sujana

doi:10.18370/2309-4117.2020.56.96-99

Cited by 4 publications

(15 citation statements)

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“…In contrast, several lines of evidence proved myo-Ins efficacy and safety in managing PCOS symptoms and improving outcomes [ 43 ], with the most promising clinical results observed in obese, insulin-resistant PCOS women, when combining myo-Ins and D-chiro-Ins in a 40:1 ratio [ 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Although other ratios were analyzed, these combinations were without a scientific rationale [ 51 ]; conversely the 40:1 ratio that may appear arbitrary, actually is similar to the plasma ratio reported in healthy women [ 51 , 52 , 53 , 54 ], thus supporting its supplementation to restore the physiological concentrations of myo-Ins and D-chiro-Ins.…”

Section: Evidence-based Effects Of Inositols Supplementation On Human Reproductionmentioning

confidence: 99%

Inositols: From Established Knowledge to Novel Approaches

Dinicola¹,

Unfer²,

Facchinetti

et al. 2021

IJMS

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Myo-inositol (myo-Ins) and D-chiro-inositol (D-chiro-Ins) are natural compounds involved in many biological pathways. Since the discovery of their involvement in endocrine signal transduction, myo-Ins and D-chiro-Ins supplementation has contributed to clinical approaches in ameliorating many gynecological and endocrinological diseases. Currently both myo-Ins and D-chiro-Ins are well-tolerated, effective alternative candidates to the classical insulin sensitizers, and are useful treatments in preventing and treating metabolic and reproductive disorders such as polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM), and male fertility disturbances, like sperm abnormalities. Moreover, besides metabolic activity, myo-Ins and D-chiro-Ins deeply influence steroidogenesis, regulating the pools of androgens and estrogens, likely in opposite ways. Given the complexity of inositol-related mechanisms of action, many of their beneficial effects are still under scrutiny. Therefore, continuing research aims to discover new emerging roles and mechanisms that can allow clinicians to tailor inositol therapy and to use it in other medical areas, hitherto unexplored. The present paper outlines the established evidence on inositols and updates on recent research, namely concerning D-chiro-Ins involvement into steroidogenesis. In particular, D-chiro-Ins mediates insulin-induced testosterone biosynthesis from ovarian thecal cells and directly affects synthesis of estrogens by modulating the expression of the aromatase enzyme. Ovaries, as well as other organs and tissues, are characterized by a specific ratio of myo-Ins to D-chiro-Ins, which ensures their healthy state and proper functionality. Altered inositol ratios may account for pathological conditions, causing an imbalance in sex hormones. Such situations usually occur in association with medical conditions, such as PCOS, or as a consequence of some pharmacological treatments. Based on the physiological role of inositols and the pathological implications of altered myo-Ins to D-chiro-Ins ratios, inositol therapy may be designed with two different aims: (1) restoring the inositol physiological ratio; (2) altering the ratio in a controlled way to achieve specific effects.

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Section: Evidence-based Effects Of Inositols Supplementation On Human Reproductionmentioning

confidence: 99%

Inositols: From Established Knowledge to Novel Approaches

Dinicola¹,

Unfer²,

Facchinetti

et al. 2021

IJMS

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“…The mean cycle length at month 3 comparing myoinositol and metformin (Figure 6) was reported by two studies [2,19] having a total sample size of 320 patients. Thalamati (2019) used the two forms of inositol, myo-inositol at 550 mg and D-chiro-inositol at 13.8 mg twice daily as the study group and metformin at 500 mg thrice daily as the control group.…”

Section: Menstruation Cycle Lengthmentioning

confidence: 90%

“…One study used only myo-inositol [14], the other four combined myo-inositol with folic acid [15][16][17][18]; and three studies included treatment arms that combined myo-inositol with metformin [2,14]. One study also used myo-inositol with its other form, which is d-chiro-inositol [19], and another one with melatonin. [17] Treatment duration lasted from two months [15] up to six months [2,19].…”

Section: Study Selectionmentioning

confidence: 99%

“…One study also used myo-inositol with its other form, which is d-chiro-inositol [19], and another one with melatonin. [17] Treatment duration lasted from two months [15] up to six months [2,19]. Three studies [16][17][18] had three months duration and one study lasted for four months.…”

Section: Study Selectionmentioning

confidence: 99%

“…Incomplete or poor reporting of allocation concealment and blinding of authors impacted the assessment, and consequently an unclear risk of bias was determined in three studies [2,15,18]. Four studies were found to have high risks of bias in two domains including concealment [14,19], and blinding. [14,16,18] Six studies reported no conflicts of interest and one study reported potential conflict of interest due to authors' affiliations.…”

Section: Bias Assessmentmentioning

confidence: 99%

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Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

Sigue¹,

Decena²

2022

JMUST

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Background: Polycystic ovarian syndrome (PCOS) is a common, reproductive endocrinopathy associated with ovarian dysfunction, cardiovascular disorders, obesity, and infertility. Myo-inositol is a novel treatment for women with PCOS that claimed to have improved fertility rate in this population. This systematic review and meta-analysis examined the effect of myo-inositol on pregnancy rate, menstrual cycle, and adverse effects from randomized controlled trials (RCTs). Methods: RCTs that evaluated the efficacy of myo-inositol in improving pregnancy rate and regulation of menstrual cycle in women with PCOS. Electronic databases were searched and studies published up to October 24, 2021 were included in the systematic review and meta-analysis. Study selection and assessment of quality were conducted independently by two review authors. Results: Seven studies with 729 patients treated with myo-inositol and 677 patients treated with placebo and/or metformin were included in the analysis. The research groups did not diverge significantly in terms of basic characteristics, such as age, adnexal or uterine pathology, body mass index, and duration of infertility. In the myo-inositol group, regulation of the normal menstrual cycle is at 20%, significantly higher than the metformin group at 12%, (p<0.001). However, there is no significant difference in the pregnancy rate between myoinositol and placebo (p=0.42) and/or metformin (p=0.17). Conclusion: This systematic review and meta-analysis showed that myo-inositol can be an alternative treatment for PCOS in terms of regulation of menses and may improve the success of spontaneous pregnancies. However, additional randomized, double-blind controlled trials with larger sample sizes, low heterogeneity, and uniform inclusion criteria are recommended to establish the effects of myo-inositol on PCOS treatment and pregnancy rate.

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TOXIC SYMPTOMS IN WISTAR STRAIN RATS ON SINGLE AND REPEATED DOSAGE FROM THE EXTRACT OF RED BETEL LEAF (Piper crocatum) AS A TOXICITY TEST OF PERIODONTAL POCKET THERAPY

Ichwana

Herryawan

2023

Journal of Health and Dental Sciences

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Red betel leaf (Piper crocatum) is one of the potential medicinal plants known to have properties to cure various diseases. The main components of betel leaf exhibit antiseptic, bactericidal, and antioxidant effects. The betel leaf was concentrated into an essential oil containing the antiseptic chemical. The antibacterial power of betel leaf essential oil is due to the content of phenolic compounds and their derivatives that can denature bacterial cell proteins, so it was considered to have potential as a material that could develop for periodontal therapy. After going through the stages of toxicity testing and repeated dose in terms of mortality, changes in body weight, and relative organ index of Wistar strain rats, the study continued to observe the effects that occurred after using single and repeated doses of 100, 400, and 1000 mg/kg BW in vivo using red betel leaf extract with the parameters of observing the behavior of rats studied for 14 days. Observation of the behavior of the test animals on toxic symptoms at each visit consisted of motor activity, straub phenomenon, piloerection, ptosis, corneal reflex, pineal reflex, lacrimation, vasodilation, catalepsy, dangling, reestablishment, walking backwards, circular walking, flexion, haffner, writhing, grooming, tremor, body shaking, vocalizations, urination, defecation, heart rate, salivation, mortality, posture, and breath changes before and after dosing for 14 days. From the observations, the analysis of the data obtained is primary data. Primary data in the form of qualitative data was obtained from data on effects that occurred after the rats were given a dose. After processing the data, the data is presented in tabular and narrative form based on the observations by showing the test dose used, the number of animals showing a toxic effect, the time of onset of a toxic effect and the percentage of animals in a group showing a toxic result. Based on the results of the study, red betel leaf extract with doses of 100, 400, and 1,000 mg/kg BW which was observed on the first and 14th days, did not cause toxic symptoms in all groups of rats, both on single administration and repeated administration for 14 days.

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A comparative study of combination of Myo-inositol and D-chiro-inositol versus Metformin in the management of polycystic ovary syndrome in obese women with infertility

Cited by 4 publications

References 0 publications

Inositols: From Established Knowledge to Novel Approaches

Inositols: From Established Knowledge to Novel Approaches

Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

TOXIC SYMPTOMS IN WISTAR STRAIN RATS ON SINGLE AND REPEATED DOSAGE FROM THE EXTRACT OF RED BETEL LEAF (Piper crocatum) AS A TOXICITY TEST OF PERIODONTAL POCKET THERAPY

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