Comparison of Metformin and N Acetylcysteine on Clinical, Metabolic Parameter and Hormonal Profile in Women with Polycystic Ovarian Syndrome

Chandil, Nidhi; Pande, Shubha; Sen, Shashwati; Gupta, Deepak Kumar

doi:10.1007/s13224-018-1135-3

Cited by 12 publications

(11 citation statements)

References 7 publications

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“…When it comes to compare the effect of NAC with other approaches causing restriction of weight gain, one small prospective study had compare the effects of NAC and Metformin on women with polycystic ovarian syndrome (PCOS). In 45 women with PCOS, there is significant improvement of body mass index, waist circumference, and weight reduction in patient using NAC, but no obvious different effect between NAC and Metformin [26]. There is still no large convincing prospective study to compare the effect of NAC to other possible approaches in weight reduction at present.…”

Section: Discussionmentioning

confidence: 99%

Long term N-acetylcysteine administration rescues liver steatosis via endoplasmic reticulum stress with unfolded protein response in mice

Tsai

Chen

et al. 2020

Lipids Health Dis

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Background: Fat accumulation in the liver contributes to the development of non-alcoholic fatty liver disease (NAFLD). N-acetylcysteine (NAC) is an antioxidant, acting both directly and indirectly via upregulation of cellular antioxidants. We examined the mechanisms of liver steatosis after 12 months high fat (HF) diet and tested the ability of NAC to rescue liver steatosis. Methods: Seven-week-old C57BL/6 (B6) male mice were administered HF diet for 12 months (HF group). Two other groups received HF diet for 12 months accompanied by NAC for 12 months (HFD + NAC(1-12)) or 6 months (HFD + NAC(1-6)). The control group was fed regular diet for 12 months (CD group). Results: Liver steatosis was more pronounced in the HF group than in the CD group after 12 month feeding. NAC intake for 6 or 12 months decreased liver steatosis in comparison with HF diet (p < 0.05). Furthermore, NAC treatment also reduced cellular apoptosis and caspase-3 expression. In the unfolded protein response (UPR) pathway, the expression of ECHS1, HSP60, and HSP70 was decreased in the HFD group (p < 0.05) and rescued by NAC therapy. With regards to the endoplasmic reticulum (ER) stress, Phospho-PERK (p-PERK) and ATF4 expression was decreased in the HF group, and only the HFD + NAC(1-12), but not HFD + NAC(1-6) group, showed significant improvement. Conclusion: HF diet for 12 months induces significant liver steatosis via altered ER stress and UPR pathway activity, as well as liver apoptosis. NAC treatment rescues the liver steatosis and apoptosis induced by HF diet.

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Section: Discussionmentioning

confidence: 99%

Long term N-acetylcysteine administration rescues liver steatosis via endoplasmic reticulum stress with unfolded protein response in mice

Tsai

Chen

et al. 2020

Lipids Health Dis

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“…The inconsistency in clinical trials regarding the effectivity of AOXs in T2D therapy, might be attributed to the huge heterogeneity between studies in several aspects of study design [98,99]. Thus, there are variations between studies with regard to inclusion/exclusion criteria; in some studies, the target population was T2D patients, whereas in other studies included prediabetic but not diabetic patients [100][101][102]. In addition, studies vary with regard to the specific type of AOX given as well as the dosage and duration of supplementation.…”

Section: Aox For the Management Of Diabetes: Limited Benefits In Clin...mentioning

confidence: 99%

Redox Balance in Type 2 Diabetes: Therapeutic Potential and the Challenge of Antioxidant-Based Therapy

Argaev-Frenkel

Rosenzweig

2023

Antioxidants

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Oxidative stress is an important factor in the development of type 2 diabetes (T2D) and associated complications. Unfortunately, most clinical studies have failed to provide sufficient evidence regarding the benefits of antioxidants (AOXs) in treating this disease. Based on the known complexity of reactive oxygen species (ROS) functions in both the physiology and pathophysiology of glucose homeostasis, it is suggested that inappropriate dosing leads to the failure of AOXs in T2D treatment. To support this hypothesis, the role of oxidative stress in the pathophysiology of T2D is described, together with a summary of the evidence for the failure of AOXs in the management of diabetes. A comparison of preclinical and clinical studies indicates that suboptimal dosing of AOXs might explain the lack of benefits of AOXs. Conversely, the possibility that glycemic control might be adversely affected by excess AOXs is also considered, based on the role of ROS in insulin signaling. We suggest that AOX therapy should be given in a personalized manner according to the need, which is the presence and severity of oxidative stress. With the development of gold-standard biomarkers for oxidative stress, optimization of AOX therapy may be achieved to maximize the therapeutic potential of these agents.

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“… 49 In addition, studies on the effects of insulin-sensitizing agents on lipidic patterns found a significant decrease in plasma lipid levels, including cholesterol, triglyceride, and LDL levels after NAC-mediated insulin-level reduction, indicating a possible additional benefit of this drug on long-term health outcomes in PCOS patients. 49–51 The efficacy of metformin in PCOS was compared with that of NAC by Chandil et al, 52 and they showed that NAC improved the clinical features of PCOS, IR biochemical marker levels, hormonal levels, and anovulation, in addition to the improved peripheral IR, more effectively than metformin did. Moreover, due to the absence of adverse effects, NAC can be regarded as an appropriate substitute for insulin sensitizer in the treatment of PCOS.…”

Section: Antioxidants In Pcosmentioning

confidence: 99%

“…Moreover, due to the absence of adverse effects, NAC can be regarded as an appropriate substitute for insulin sensitizer in the treatment of PCOS. 52 In a study by Cheraghi et al, 53 60 women with PCOS who underwent intracytoplasmic sperm injection (ICSI) were divided into four groups and received either metformin (1500 mg/day), NAC (1800 mg/day), metformin + NAC, or a placebo for six weeks. They found that the number of immature and abnormal oocytes substantially decreased with a concomitant increase in the number of good-quality embryos in the NAC group as compared to that of the placebo group.…”

Section: Antioxidants In Pcosmentioning

confidence: 99%

Clinical and Biochemical Potential of Antioxidants in Treating Polycystic Ovary Syndrome

Cheng

2022

IJWH

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Polycystic ovary syndrome (PCOS) is the most common cause of infertility in reproductive-age women. Increased reactive oxygen species levels and decreased antioxidant capacity in PCOS patients can lead to metabolic disorders and damage the ovarian tissues, resulting in the occurrence of related symptoms. Antioxidants have been used in the treatment of PCOS and have yielded satisfactory outcomes due to their ability to counter oxidative stress. Many experiments on PCOS patients have proved that antioxidants can not only improve the ovarian environment, promote follicular maturation, and elevate oocyte quantities but can also regulate lipid and glucose metabolism as well as vascular endothelial cell function in PCOS patients, thereby attenuating adiposity and reducing the occurrence rate of chronic complications to ensure that patients can obtain long-term benefits. This review describes the use of antioxidants in PCOS, which have been used in the treatment.

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Comparison of Metformin and N Acetylcysteine on Clinical, Metabolic Parameter and Hormonal Profile in Women with Polycystic Ovarian Syndrome

Abstract: Objective Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome. Design Prospective comparative study. Setting Obstetrics and Gynecology department in Kamala Nehru Memorial Hospital Allahabad.

Cited by 12 publications

References 7 publications

Long term N-acetylcysteine administration rescues liver steatosis via endoplasmic reticulum stress with unfolded protein response in mice

Long term N-acetylcysteine administration rescues liver steatosis via endoplasmic reticulum stress with unfolded protein response in mice

Redox Balance in Type 2 Diabetes: Therapeutic Potential and the Challenge of Antioxidant-Based Therapy

Clinical and Biochemical Potential of Antioxidants in Treating Polycystic Ovary Syndrome

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