Experts’ opinion on inositols in treating polycystic ovary syndrome and non-insulin dependent diabetes mellitus: a further help for human reproduction and beyond

Facchinetti, Fabio; Appetecchia, Marialuisa; Aragona, Cesare; Bevilacqua, Arturo; Espinola, Maria Salomé Bezerra; Bizzarri, Mariano; D’Anna, Rosario; Dewailly, Didier; Diamanti-Kandarakis, Evanthia; Marín, Imelda Hernández; Kamenov, Zdravko; Kandaraki, Eleni; Laganà, Antonio Simone; Monastra, Giovanni; Oliva, Mario Montanino; Nestler, John E.; Orio, Francesco; Özay, Ali Cenk; Papalou, Olga; Pkhaladze, Lali; Porcaro, Giusy; Prapas, Nikos; Soulage, Christophe O.; Stringaro, Annarita; Wdowiak, Artur; Unfer, Vittorio

doi:10.1080/17425255.2020.1737675

Cited by 54 publications

(57 citation statements)

References 146 publications

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“…During the last decades, compelling evidence confirmed inositol supplementation as a pivotal and well tolerated integrative treatment for PCOS-affected women [ 11 , 12 ].…”

Section: The Rationale Of the Use Of Inositol For Pcos Treatmentmentioning

confidence: 99%

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

Unfer

Dinicola

Laganà

et al. 2020

IJMS

Self Cite

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The presence of abnormal ovarian ratios of myo-inositol (MI) to D-chiro-inositol (DCI) is a recurrent feature in PCOS. Available evidence suggests that MI and DCI may modulate steroid biosynthesis, likely in an opposite manner. Specifically, MI seems to induce estrogen production, while DCI has a role in the synthesis of androgens. Elevated insulin levels, generally associated with PCOS, alter the physiological MI/DCI ratio, increasing MI-to-DCI conversion through activation of a specific epimerase enzyme. DCI directly increases testosterone biosynthesis in thecal cells and reduces its conversion to estradiol by downregulating aromatase enzyme in granulosa cells. This manuscript reviews the literature that supports the connection between altered MI/DCI ratios and pathological steroidogenesis observed in PCOS women. Furthermore, it discusses the application of inositol-based treatment protocols in managing PCOS symptoms and improving the quality of patients’ life.

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“…During the last decades, compelling evidence confirmed inositol supplementation as a pivotal and well tolerated integrative treatment for PCOS-affected women [ 11 , 12 ].…”

Section: The Rationale Of the Use Of Inositol For Pcos Treatmentmentioning

confidence: 99%

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

Unfer

Dinicola

Laganà

et al. 2020

IJMS

Self Cite

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“…A possibility to enhance the effect of metformin and reduce its dosage can be provided by administration of inositols. According to the latest research, inositols are similarly effective in combating insulin resistance and the subsequent hyperinsulinemia in the treatment of PCOS [ 120 , 121 , 122 , 123 ].…”

Section: Discussionmentioning

confidence: 99%

“…The results of studies with myo-inositol were comparable to those obtained with metformin treatment, which makes it an effective and safe therapeutic option in women with PCOS suffering from insulin resistance [ 120 ]. Nevertheless, there still remain some unresolved problematic issues in inositol-based treatment of PCOS [ 121 , 122 , 123 ]. One of those issues is the therapeutic inefficacy of these compounds in some patients (in 30–40% of PCOS patients).…”

Section: Potential Drug Targets and Active Substances In Novel Thementioning

confidence: 99%

“…A possible way to overcome that problem is to combine the administration of MI with alpha-lactalbumin. Furthermore, however, the reports concerning fertility outcomes are conflicting [ 121 , 122 ]. From this perspective, further research is needed to optimize administration modes and the best combinations of MI, DCI and alpha-lactalbumin for different PCOS phenotypes.…”

Section: Potential Drug Targets and Active Substances In Novel Thementioning

confidence: 99%

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In Search of New Therapeutics—Molecular Aspects of the PCOS Pathophysiology: Genetics, Hormones, Metabolism and Beyond

Wawrzkiewicz-Jałowiecka

Kowalczyk

Trybek

et al. 2020

IJMS

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In a healthy female reproductive system, a subtle hormonal and metabolic dance leads to repetitive cyclic changes in the ovaries and uterus, which make an effective ovulation and potential implantation of an embryo possible. However, that is not so in the case of polycystic ovary syndrome (PCOS), in which case the central mechanism responsible for entraining hormonal and metabolic rhythms during the menstrual cycle is notably disrupted. In this review we provide a detailed description of the possible scenario of PCOS pathogenesis. We begin from the analysis of how a set of genetic disorders related to PCOS leads to particular malfunctions at a molecular level (e.g., increased enzyme activities of cytochrome P450 (CYP) type 17A1 (17α-hydroxylase), 3β-HSD type II and CYP type 11A1 (side-chain cleavage enzyme) in theca cells, or changes in the expression of aquaporins in granulosa cells) and discuss further cellular- and tissue-level consequences (e.g., anovulation, elevated levels of the advanced glycation end products in ovaries), which in turn lead to the observed subsequent systemic symptoms. Since gene-editing therapy is currently out of reach, herein special emphasis is placed on discussing what kinds of drug targets and which potentially active substances seem promising for an effective medication, acting on the primary causes of PCOS on a molecular level.

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“…High pre-pregnancy BMI is a risk factor for GDM and developing type 2 diabetes mellitus after pregnancy [68]. GDM can lead to disturbances in fetal development, including fetal macrosomia and a four to five times higher rate of congenital malformations than in the non-diabetic population [69]. BS and the following reduction of body weight leads to an important decrease in the rate of GDM, when compared to the obese population, and in some studies even to the general non-obese population.…”

Section: Gestational Diabetes Mellitusmentioning

confidence: 99%

Pregnancy after bariatric surgery - a narrative literature review.

Różańska-Walędziak

Bartnik

Czajkowski

2020

Videosurgery and Other Miniinvasive Techniques

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The purpose of this review was to analyze the literature about pregnancy after bariatric surgery. We searched for available articles on the subject from the last decade (2010 to 2020). The positive impact of bariatric surgery on the level of comorbidities and pregnancy and neonatal outcomes cannot be overrated. Weight loss after bariatric surgery reduces the incidence of obesity-related conditions in pregnancy. A pregnancy in a woman after bariatric surgery should be considered a high-risk pregnancy and taken care of by a multidisciplinary team with appropriate micronutrient and vitamin supplementation provided. Optimum time to conception should be chosen following the international recommendations. Every woman after bariatric surgery should be aware of symptoms of surgical complications and immediately contact their surgeon in case of abdominal pain.

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Experts’ opinion on inositols in treating polycystic ovary syndrome and non-insulin dependent diabetes mellitus: a further help for human reproduction and beyond

Cited by 54 publications

References 146 publications

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

In Search of New Therapeutics—Molecular Aspects of the PCOS Pathophysiology: Genetics, Hormones, Metabolism and Beyond

Pregnancy after bariatric surgery - a narrative literature review.

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