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:10.18203/2320-1770.ijrcog20190498

Cited by 6 publications

(7 citation statements)

References 15 publications

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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: Inositol Supplementation and Female Reproduction (Pcos Metabolism And Ovulation)mentioning

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: Inositol Supplementation and Female Reproduction (Pcos Metabolism And Ovulation)mentioning

confidence: 99%

Inositols: From Established Knowledge to Novel Approaches

Dinicola¹,

Unfer²,

Facchinetti

et al. 2021

IJMS

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“…There was remarkable reduction in LH, fasting insulin, and HOMA index in patients treated with MI-DCI combination therapy versus placebo [13].In a previous study the Myo-inositol group had significantly reduced serum total testosterone from 99.5to 34.8 ng/dL, and free testosterone from 0.85 to 0.24 ng/dL when compared to those in the placebo group, p=0.01) [13]. The LH/FSH ratio was attenuated after twice-daily treatment with MI-DCI combination therapy in a previous study (n=200) reporting reduced gonadotropin ratio from baseline (2.85) to 12 weeks (2.47) and 24 weeks (1.83) [15]. PCOS is accompanied by insulin resistance affecting 65-70% of all patients [1].…”

Section: Global Evaluation Of Efficacy (Pgee) and Tolerability (Pget)mentioning

confidence: 89%

“…In a previous study the Myo-inositol group had significantly reduced serum total testosterone from 99.5 to 34.8 ng/dL, and free testosterone from 0.85 to 0.24 ng/dL when compared to those in the placebo group, p=0.01) [ 13 ]. The LH/FSH ratio was attenuated after twice-daily treatment with MI-DCI combination therapy in a previous study (n=200) reporting reduced gonadotropin ratio from baseline (2.85) to 12 weeks (2.47) and 24 weeks (1.83) [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Management of polycystic ovary syndrome among Indian women using myo‐inositol and D-chiro-inositol

Vyas¹

2022

Bioinformation

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Myo-Inositol and D-chiro-inositol (MI-DCI) are used in the treatment of polycystic ovarian syndrome (PCOS) due to their insulin-sensitizing actions. Therefore, it is of interest to evaluate the treatment patterns, clinical effectiveness and safety of MI-DCI combination in management of PCOS in Indian women .Data from 50 healthcare centers across India between September 2019 and February 2020 were used in the study. Women aged 12-45 years diagnosed with PCOS, who had received MI-DCI (550-150 mg) were included. The outcome parameters were change in weight, luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio, hirsutism, blood glucose and insulin levels, HOMA-IR, and lipid profile. 283 women (mean age: 27.74 years; body mass index: 26.89 kg/m2); of which 197 (69.61%) reported reduction in weight after treatment with MI-DCI. The proportion of hirsutism score reduced after treatment, no hirsutism increased from 31.07% to 50.51% and the severe reduced from 4.85% to zero and moderate from 32.52% to 6.12%. There was a significant reduction in LH:FSH ratio (mean difference: 0.25 mg/dL; p=0.021), free testosterone (mean difference: 1.49; p<0.001) and dehydroepiandrosterone (mean difference: 21.49; P<0.001) levels after regular use of MI-DCI tablets.Treatment with MI-DCI resulted in significant improvement in insulin, HOMA score, FPG, PPG and lipid profile. The therapy restored menstruation and spontaneous ovulation and significantly attenuated the LH/FSH ratio. Thus, MI-DCI (550-150 mg) has shown multidimensional benefits in improving the hormonal, glycemic, and lipid profile of women with PCOS with considerable efficacy and tolerability.

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“…В исследовании S. Thalamati применение комбинации МИ и ДХИ в сравнении с метформином показало сопоставимое влияние на тощаковый инсулин и индекс HOMA-IR. При этом было выявлено преимущество влияния комбинации МИ и ДХИ на длительность и регулярность менструального цикла у пациенток с СПЯ, а также на соотношение ЛГ/ФСГ и СТ [40].…”

Section: репродуктивное здоровье и вртunclassified

Target therapy of polycystic ovary syndrome

et al. 2023

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Due to the complexity of the diagnosis and treatment of polycystic ovary syndrome (PCOS) in adolescents, studies are currently underway to select targeted therapy to normalize the metabolic and reproductive status of girls, including those at risk for PCOS. There are a lot of researches, that evaluate the effectiveness of inositol therapy in PCOS, ovarian dysfunction, insulin resistance (IR), ovarian hyperandrogenism in both adolescents and adult women, including those in IVF cycles. Currently, the choice of determining the ratio of myo-inositol (MI) and d-chiro-inositol (DCI) for the treatment of PCOS often leads to the physiological proportion of inositols in plasma (40:1), since research results are insufficient to unambiguously confirm it. In this connection, there is a large number of pharmaceuticals without or with a low dosage of DCI, that can’t bypass the defective epimerase activity and achieve an adequate level of DCI in the ovaries. Determination of a fair assessment and dosage of MI/DCI is required for long-term correction of metabolic, endocrinological and clinical manifestations of various PCOS phenotypes. Inositols are promising and safe treatment of hyperandrogenism, obesity, insulin resistance in women of various age groups and can also effectively complement a therapeutic effect of metformin and combined oral contraceptives.

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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 6 publications

References 15 publications

Inositols: From Established Knowledge to Novel Approaches

Inositols: From Established Knowledge to Novel Approaches

Management of polycystic ovary syndrome among Indian women using myo‐inositol and D-chiro-inositol

Target therapy of polycystic ovary syndrome

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