Treatment with combined resveratrol and myoinositol ameliorates endocrine, metabolic alterations and perceived stress response in women with PCOS: a double-blind randomized clinical trial

Abstract

Purpose: The present study aimed to assess whether treatment with combined resveratrol and myoinositol is more effective in ameliorating the altered parameters associated with PCOS when compared to the combined metformin and pioglitazone therapy.Method: One hundred and ten obese, infertile PCOS women, aged 20-35 years were randomly assigned into two treatment arms. Participants in arm-1 (n=55), received combination of metformin and pioglitazone (1000 mg and 30 mg, respectively), once daily, while those in arm-2 (n=55) received combination of resveratrol and myoinositol (2000 mg and 2000 mg, respectively) once daily for 12 weeks. Evaluations performed at baseline were repeated after 3 months of therapy. The endocrine and metabolic derangements were assessed by measuring serum levels of testosterone, luteinizing hormone, follicle stimulating hormone, adiponectin and insulin using ELISA. Cohen's perceived stress scale (PSS) was employed as a subjective measure of stress.Results: Pre-treatment PCOS women in both the arms (arm-1 and arm-2) had remarkably elevated serum testosterone and insulin concentrations, low serum adiponectin and high perceived stress response scores. The treatment reduced the altered endocrine indices in arm-2 (resveratrol and myoinositol) participants, manifested by statistically signi cant reduction in serum testosterone level (p=0.001) and notably increased serum adiponectin level (p=0.001). Interestingly, the hormonal pro le, including serum LH and FSH levels also decreased (p<0.001) along with a marked reduction in the ovarian volume (p=0.001) in arm-2 participants. There was a signi cant reduction in BMI (p<0.001) and an improvement in waist-hip ratio (p<0.001) in arm-2 participants compared to arm-1 group. The PSS scores of the arm-2 subjects improved signi cantly (p<0.001) whereas, the Ferrimen-gallwey score was improved in both the arms (arm-1 and arm-2; p= 0.010 and 0.008 respectively) however, the change was highly signi cant in arm-2 (resveratrol and myoinositol). Interestingly, the menstrual regularity was 81.4% in arm-2 while 18.2% in arm-1. We conclude that the therapeutic intervention with combined resveratrol and myoinositol is more effective in ameliorating altered endocrine, metabolic indices and stress burden and could be of clinical importance in high risk group of obese, infertile married PCOS affected women.

Molecular Mechanism of Resveratrol and Its Therapeutic Potential on Female Infertility

“…The results showed improvement in ovarian morphology, but due to the small sample size, more studies with larger participant numbers need to be conducted. Two additional randomized controlled trials on PCOS patients exploring the combinatory effect of resveratrol + myoinositol [162] and resveratrol + lipoic acid [163] were recently performed. Both studies observed beneficial effects on endocrine, stress, and metabolic parameters.…”

Resveratrol: A Review on the Biological Activity and Applications

“…In a study involving 110 patients, the treatment with both RSV and myoinositol was substantially more efficient than metformin and pioglitazone in improving abnormal endocrine, metabolic markers and stress burden and has excellent potential in the high-risk category of obese, oligo-anovulatory women with PCOS [165]. Another inquiry established that the protective actions of RSV on ovulation in rats with PCOS are correlated to the modulation of glycolysis-dependent mediators, such as pyruvate kinase isozyme M2, lactate dehydrogenase A, and SIRT1 [166].…”

Therapeutic developments for valosin-containing protein mediated multisystem proteinopathy

“…Apart from the above-mentioned studies, based on our understanding of VCP-MSP, antioxidant, antiinflammatory agents, such as dietary natural stilbenes polyphenol, Resveratrol (RV), can be a potential intervention in VCP-MSP. Resveratrol decreases apoptosis, inflammation, mitochondrial dysfunction, and helps improve lifespan with its antioxidant capabilities, and it has been safely used in several clinical trials [60][61][62]. Given the underlying mitochondrial pathology in VCP-MSP, including hindered ATP production, mitochondrial modifiers can be theoretically beneficial [63].…”