<scp>d</scp>-Chiro-inositol and its significance in polycystic ovary syndrome: a systematic review

Galazis, Nicolas; Galazi, Myria; Atiomo, William

doi:10.3109/09513590.2010.538099

Cited by 46 publications

(49 citation statements)

References 20 publications

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“…Increasing evidence has demonstrated that myo-ins plays a key role in cell morphogenesis and cytogenesis, lipid synthesis, structure of cell membranes, and cell growth [10]. Myo-Ins administration improves hormonal profile, oocyte maturation, and insulin resistance; furthermore, it promotes the meiotic progression of germinal vesicle oocytes [11, 12]. Recent studies on PCOS patients showed a decrease of androgen levels and an improvement in ovulation and metabolic parameters after treatment with myo-ins and D-chiro-inositol (D-chiro-ins), which is another stereoisomeric form of inositol [13].…”

Section: Introductionmentioning

confidence: 99%

Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

Özay

Okyay

et al. 2016

International Journal of Endocrinology

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Recently, myoinositol (myo-ins) and folic acid combination has gained an important role for treating Polycystic Ovary Syndrome (PCOS), in addition to combined oral contraceptives (COC). We aimed to examine myo-ins effects on anti-Mullerian hormone (AMH) levels and compare them with those ones obtained administering COC. In this prospective study, 137 PCOS patients, diagnosed according to Rotterdam criteria and admitted to the Reproductive Endocrinology and Infertility Outpatient Clinic at Dokuz Eylul University (Izmir, Turkey), were included. After randomization to COC (n = 60) and myo-ins (n = 77) arms, anthropometric measurements, blood pressure, Modified Ferriman Gallwey scores were calculated. Biochemical and hormonal analysis were performed, and LH/FSH and Apo B/A1 ratios were calculated. Data analysis was carried out in demographically and clinically matched 106 patients (COC = 54; myo-ins = 52). After 3-month treatment, increase in HDL and decreases in LH and LH/FSH ratio were statistically more significant only in COC group when compared with baseline (in both cases p > 0.05). In myo-ins group, fasting glucose, LDL, DHEAS, total cholesterol, and prolactin levels decreased significantly (for all p < 0.05). Progesterone and AMH levels, ovarian volume, ovarian antral follicle, and total antral follicle counts lessened significantly in both groups (for all p < 0.05). In PCOS treatment, MYO is observed more effective in reductions of total ovarian volume and AMH levels.

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Section: Introductionmentioning

confidence: 99%

Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

Özay

Okyay

et al. 2016

International Journal of Endocrinology

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“…Consequently, authors suggested that the insulin resistance observed in PCOS women is related, at least partially, to the defect in one of the mediators of insulin containing D-chiro-inositol (Bromberg and Edlich, 1994[8]). Metformin ameliorates insulin action in PCOS patients through releasing D-chiro-inositol-IPG mediator (Galazis et al, 2011[24]). Myo-inositol is the most common form of inositol, which is converted to D-chiro-inositol by an epimerase (Larner, 2002[40]).…”

Section: Nutrients and Pcosmentioning

confidence: 99%

“…Nevertheless, myo-inositol potentially improves the metabolic profile, whereas D-chiro-inositol exerts positive effects on hyperandrogenism (Pizzo et al, 2014[60]). Yet, a systematic review assessing the effects of D-chiro-inositol on ovulation and/or metabolic markers in PCOS failed to find consistent conclusion, mostly because of heterogeneity in the method of each study and also lack of relevant trials and small sample sizes (Galazis et al, 2011[24]). Finally, Unfer et al (2012[76]) performed a meta-analysis of 6 randomized placebo-controlled trials which used a range of 0.2-4 g/day myo-inositol in PCOS patients and concluded that myo-inositol supplementation can decrease the levels of various hormones such as LH, LH/follicle stimulating hormone (FSH), PRL, and testosterone and improve the dyslipidemia by reducing insulin concentrations.…”

Section: Nutrients and Pcosmentioning

confidence: 99%

“…Although, only few randomized controlled trials (RCTs) using small sample size have been conducted (Galazis et al, 2011[24]; Unfer et al, 2012[76]). Several studies have reported to date the positive effects of myo-inositol and D-chiro-inositol on clinical, metabolic, endocrine, hormonal, and oxidative abnormalities in women with PCOS.…”

Section: Nutrients and Pcosmentioning

confidence: 99%

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Nutrients as novel therapeutic approaches for metabolic disturbances in polycystic ovary syndrome

Mansour

Hosseini

Larijani

et al. 2016

EXCLI Journal; 15:Doc551; ISSN 1611-2156

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“…As evidenced by Vitagliano et al, despite the plethora of published papers about the treatment of PCOS with Inositol isoforms (for systematic reviews, see Unfer et al [3] and Galazis et al [4]), very few of them focused on lean patients (BMI \ 25).…”

Section: Dear Editormentioning

confidence: 99%

Authors’ reply to: “Empiric” inositol supplementation in normal-weight non-insulin resistant women with polycystic ovarian disease: from the absence of benefit to the potential adverse effects

Laganà

Pizzo

2015

Arch Gynecol Obstet

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Ó Springer-Verlag Berlin Heidelberg 2015 Dear Editor, We appreciate Vitagliano and Colleagues' interest in our recent article [1] about ovarian function and metabolic factors in women affected by polycystic ovary syndrome (PCOS) after treatment with D-chiro-inositol. We are grateful for their insightful comments [2] and the opportunity to clarify a number of elements from our work. As evidenced by Vitagliano et al., despite the plethora of published papers about the treatment of PCOS with Inositol isoforms (for systematic reviews, see Unfer et al. [3] and Galazis et al. [4]), very few of them focused on lean patients (BMI \ 25).Accumulating evidence suggests that pre-treatment BMI may play a key role in the effect of inositol treatment of PCOS: Genazzani et al. [5] recently showed D-chiroinositol administration is effective in restoring better insulin sensitivity and an improved hormonal pattern in obese hyperinsulinemic PCOS patients, in particular, in hyperinsulinemic PCOS patients who have diabetic relatives. In our previous study [1], even if all the recruited patients were lean, we reported 5.38 ± 1.54 as mean glycaemia/IRI ratio and 3.44 ± 1.18 as mean HOMA (Homeostasis Model Assessment) index, so we evidenced insulin resistance/hyperglycaemia (HOMA C 2.5) in the enrolled population. Moreover, none of these patients had diabetic relatives (first or second degree).In this context, it was recently evidenced [6] that even in the absence of insulin resistance, the rate of anovulation in PCOS remains still high. As interestingly suggested by Vitagliano's group, the percentage of poor responder in our study could depend (at least in part) by a subgroup of noninsulin resistant lean PCOS patients.Moreover, some authors [7] found no change in D-chiroinositol-containing inositolphosphoglycan (DCI-IPG) release, suggesting that impaired DCI-IPG release in these women may have represented a functional defect (e.g., intracellular defect in formation or release of the DCI-IPG mediator) rather than a simple nutritional deficiency in the substrate D-chiro-inositol. Nevertheless, also this study is strongly conditioned by very small samples (just 6 patients in the D-chiro-inositol group and 5 in the placebo group) and it is unclear why the authors choose to administrate 1200 mg of the study drug.Vitagliano's hypothesis, even it has to be confirmed by future studies, could explain also why some other authors [8] found that very (unnecessary?) high dosages (1200-2400 mg daily) of D-chiro-inositol may worse oocyte quality and ovarian response in PCOS patients without insulin resistance and/or hyperglycaemia after induction of ovulation.We previously evidenced [9, 10] that both the isoforms of inositol were effective in improving ovarian function and metabolism in patients with PCOS, although myoinositol showed the most marked effect on the metabolic profile, whereas D-chiro-inositol reduced hyperandrogenism better. This conflicting results could depend on the different selection of the patients (Isabella and Raffone [8] selecte...

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d-Chiro-inositol and its significance in polycystic ovary syndrome: a systematic review

Abstract: Heterogeneity observed in the methodologies of each study, the scarcity of relevant studies and the small sample sizes used prohibit reliable conclusions to be drawn. Therefore, more studies must be conducted in the future to evaluate accurately the effects of DCI in PCOS.

Cited by 46 publications

References 20 publications

Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

Nutrients as novel therapeutic approaches for metabolic disturbances in polycystic ovary syndrome

Authors’ reply to: “Empiric” inositol supplementation in normal-weight non-insulin resistant women with polycystic ovarian disease: from the absence of benefit to the potential adverse effects

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