Abstract:Insulin resistance (IR) plays a pivotal role in PCOS. Insulin-sensitizer agents such as metformin and inositols have been shown to improve the endocrine and metabolic aspects of PCOS. The purpose of this study is to compare their effects on the clinical and metabolic features of the women with PCOS. Fifty PCOS women with IR and/or hyperinsulinemia were randomized to treatment with metformin (1500 mg/day) or myo-inositol (4 g/day). IR was defined as HOMA-IR >2.5, while hyperinsulinemia was defined as a value of… Show more
“…Our results are in consistence with the study conducted by Fruzzetti et al, where both metformin and myoinositol group presented with decrease in insulin levels after treatment. 16 Similar results have been reported with the use of metformin and myoinositol on insulin levels by Pradas et al and Artini et al, respectively. 10,14 The results of the study conducted by Shokrpour et al are in consonance with our results showing significant reduction in serum insulin levels with myoinositol supplementation.…”
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Insulin resistance and resultant hyperinsulinemia contribute to hyperandrogenism in these patients. Weight loss or pharmacologic interventions that lower insulin levels reduce androgen levels. This study was planned to evaluate efficacy of metformin versus myoinositol plus d-chiroinositol combination therapy in PCOS patients and its effects on clinical, hormonal and radio diagnostic dimensions.Methods: This was a prospective study for nine months. 50 newly diagnosed PCOS patients from the Department of Obstetrics and Gynaecology, Government Medical College (GMC), Amritsar, were randomly divided into 2 groups. One group was given metformin 500 mg twice daily and another myoinositol plus d-chiroinositol 1000 mg twice daily for 9 months. Follow up was done at 3, 6, 9 months. At each visit, ultrasonography and hormone levels were evaluated. Informed consent was taken. The approval of the Institutional Ethics Committee, GMC, Amritsar was also obtained.Results: The percentage change in free testosterone levels (22.46±6.47) and insulin levels (34.24±15.02) show statistically significant decrease in group 2 (p<0.001). There was statistically significant (p<0.05) fall in AMH levels (22.41±7.78) in group 1. There was no statistically significant difference between the 2 groups in ovarian volume on ultrasonography, random blood glucose levels, luteinizing hormone (LH), follicle-stimulating hormone (FSH) levels, estrogen and progesterone levels.Conclusions: It was observed that both treatments are equally effective in the treatment of polycystic ovarian syndrome with better tolerability in myoinositol and d-chiroinositol group.
“…Our results are in consistence with the study conducted by Fruzzetti et al, where both metformin and myoinositol group presented with decrease in insulin levels after treatment. 16 Similar results have been reported with the use of metformin and myoinositol on insulin levels by Pradas et al and Artini et al, respectively. 10,14 The results of the study conducted by Shokrpour et al are in consonance with our results showing significant reduction in serum insulin levels with myoinositol supplementation.…”
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Insulin resistance and resultant hyperinsulinemia contribute to hyperandrogenism in these patients. Weight loss or pharmacologic interventions that lower insulin levels reduce androgen levels. This study was planned to evaluate efficacy of metformin versus myoinositol plus d-chiroinositol combination therapy in PCOS patients and its effects on clinical, hormonal and radio diagnostic dimensions.Methods: This was a prospective study for nine months. 50 newly diagnosed PCOS patients from the Department of Obstetrics and Gynaecology, Government Medical College (GMC), Amritsar, were randomly divided into 2 groups. One group was given metformin 500 mg twice daily and another myoinositol plus d-chiroinositol 1000 mg twice daily for 9 months. Follow up was done at 3, 6, 9 months. At each visit, ultrasonography and hormone levels were evaluated. Informed consent was taken. The approval of the Institutional Ethics Committee, GMC, Amritsar was also obtained.Results: The percentage change in free testosterone levels (22.46±6.47) and insulin levels (34.24±15.02) show statistically significant decrease in group 2 (p<0.001). There was statistically significant (p<0.05) fall in AMH levels (22.41±7.78) in group 1. There was no statistically significant difference between the 2 groups in ovarian volume on ultrasonography, random blood glucose levels, luteinizing hormone (LH), follicle-stimulating hormone (FSH) levels, estrogen and progesterone levels.Conclusions: It was observed that both treatments are equally effective in the treatment of polycystic ovarian syndrome with better tolerability in myoinositol and d-chiroinositol group.
“…The remaining 18 articles were assessed for eligibility, and 9 articles which met the criteria were finally included in the meta-analysis. Studies were excluded for several reasons including (a) data of the outcome were unavailable or not expressed in the numerical form ( 39 ), (b) patients were treated with MI combined with other molecules such as multivitamin complex ( 40 ), lactoferrin and bromelin ( 41 ) or oral contraceptives pills (OCPs) ( 42 ), (c) menopausal women with metabolic syndrome ( 4 , 5 ) and (d) the study was a non-randomized design ( 43 , 44 , 45 ). Figure 1 PRISMA (preferred reporting items for systematic reviews and meta-analyses) flow diagram of study selection ( 38 ).…”
Myo-inositol (MI) supplementation in women with polycystic ovary syndrome (PCOS) has been evaluated over the last years. Many hormonal and reproductive impairments associated with this disorder seem relieved by the supplement. The objective of the meta-analysis was to assess the effects of MI alone or combined with d-chiro-inositol (DCI) on the endocrine and metabolic abnormalities of women with PCOS. Literature was retrieved from selected databases, MEDLINE, EMBASE, PubMed and Research Gate (up to November 2016). Only randomized controlled trials (RCTs) investigating the effects of MI alone or combined with DCI were reviewed. Nine RCTs involving 247 cases and 249 controls were included. Significant decreases in fasting insulin (SMD = −1.021 µU/mL, 95% CI: −1.791 to −0.251, P = 0.009) and homeostasis model assessment (HOMA) index (SMD = −0.585, 95% CI: −1.145 to −0.025, P = 0.041) were identified after MI supplementation. The trial sequential analysis of insulin meta-analysis illustrates that the cumulative z-curve crossed the monitoring boundary, providing firm evidence of the intervention effect. A slight trend toward a reduction of testosterone concentration by MI with respect to controls was found (SMD = −0.49, 95% CI: −1.072 to 0.092, P = 0.099), whereas androstenedione levels remained unaffected. Throughout a subgroup’s meta-analysis, a significant increase in serum SHBG was observed only in those studies where MI was administered for at least 24 weeks (SMD = 0.425 nmol/L, 95% CI: 0.050–0.801, P = 0.026). These results highlight the beneficial effect of MI in improving the metabolic profile of women with PCOS, concomitantly reducing their hyperandrogenism.
“…Considering the accumulating evidence on this topic, several studies investigated the effects of combined DCI and MI, demonstrating a better and faster re-addressing of hormonal and metabolic parameters in PCOS population, maintaining the widely known safety profile ( 1 ). Although the last Cochrane systematic review about the topic does not offer a robust recommendation about the best treatment for PCOS among metformin, rosiglitazone, pioglitazone and DCI ( 8 ), a recent trial did not find any significant difference between metformin and MI in lowering BMI, ameliorating insulin sensitivity, and improving menstrual cycle ( 9 ). Nevertheless, in the evaluation of the available evidence, we should consider that Inositol administration is more effective in obese patients with high fasting insulin plasma levels ( 10 ).…”
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