The inositols and polycystic ovary syndrome

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Abstract

This review describes the rationale, biochemical, and clinical data related to the use of inositols in polycystic ovary syndrome (PCOS). It covers studies related to the mechanism of action of myo-inositol and D-chiro-inositol (MDI), with randomized controlled trials conducted in women with PCOS, and utilizes these data to suggest pragmatic indications and methods for using MDI combination in PCOS. Rationally crafted inositol combinations have a potential role to play in maintaining metabolic, endocrine, and reproductive health in women with PCOS.

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Most cited references 23

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D-chiro-inositol glycans in insulin signaling and insulin resistance.

Joseph Larner, David Brautigan, Michael Thorner (2024)

Classical actions of insulin involve increased glucose uptake from the bloodstream and its metabolism in peripheral tissues, the most important and relevant effects for human health. However, nonoxidative and oxidative glucose disposal by activation of glycogen synthase (GS) and mitochondrial pyruvate dehydrogenase (PDH) remain incompletely explained by current models for insulin action. Since the discovery of insulin receptor Tyr kinase activity about 25 years ago, the dominant paradigm for intracellular signaling by insulin invokes protein phosphorylation downstream of the receptor and its primary Tyr phosphorylated substrates-the insulin receptor substrate family of proteins. This scheme accounts for most, but not all, intracellular actions of insulin. Essentially forgotten is the previous literature and continuing work on second messengers generated in cells in response to insulin. Treatment and even prevention of diabetes and metabolic syndrome will benefit from a more complete elucidation of cellular-signaling events activated by insulin, to include the actions of second messengers such as glycan molecules that contain D-chiro-inositol (DCI). The metabolism of DCI is associated with insulin sensitivity and resistance, supporting the concept that second messengers have a role in responses to and resistance to insulin.

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Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.

G Carlomagno, F Facchinetti, G Dante … (2012)

Polycystic ovary syndrome (PCOS) affects 5%-10% of women in reproductive age, and it is the most common cause of infertility due to ovarian dysfunction and menstrual irregularity. Several studies have reported that insulin resistance is common in PCOS women, regardless of the body mass index. The importance of insulin resistance in PCOS is also suggested by the fact that insulin-sensitizing compounds have been proposed as putative treatments to solve the hyperinsulinemia-induced dysfunction of ovarian response to endogenous gonadotropins. Rescuing the ovarian response to endogenous gonadotropins reduces hyperandrogenemia and re-establishes menstrual cyclicity and ovulation, increasing the chance of a spontaneous pregnancy. Among the insulin-sensitizing compounds, there is myo-inosiol (MYO). Previous studies have demonstrated that MYO is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with PCOS. With the present review, we aim to provide an overview on the clinical outcomes of the MYO use as a treatment to improve ovarian function and metabolic and hormonal parameters in women with PCOS.

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Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS

Fabio Facchinetti, Mariano Bizzarri, Salvatore Benvenga … (2015)

In recent years, interest has been focused to the study of the two major inositol stereoisomers: myo-inositol (MI) and d-chiro-inositol (DCI), because of their involvement, as second messengers of insulin, in several insulin-dependent processes, such as metabolic syndrome and polycystic ovary syndrome. Although these molecules have different functions, very often their roles have been confused, while the meaning of several observations still needs to be interpreted under a more rigorous physiological framework. With the aim of clarifying this issue, the 2013 International Consensus Conference on MI and DCI in Obstetrics and Gynecology identified opinion leaders in all fields related to this area of research. They examined seminal experimental papers and randomized clinical trials reporting the role and the use of inositol(s) in clinical practice. The main topics were the relation between inositol(s) and metabolic syndrome, polycystic ovary syndrome (with a focus on both metabolic and reproductive aspects), congenital anomalies, gestational diabetes. Clinical trials demonstrated that inositol(s) supplementation could fruitfully affect different pathophysiological aspects of disorders pertaining Obstetrics and Gynecology. The treatment of PCOS women as well as the prevention of GDM seem those clinical conditions which take more advantages from MI supplementation, when used at a dose of 2g twice/day. The clinical experience with MI is largely superior to the one with DCI. However, the existence of tissue-specific ratios, namely in the ovary, has prompted researchers to recently develop a treatment based on both molecules in the proportion of 40 (MI) to 1 (DCI).

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Journal

Journal ID (nlm-ta): Indian J Endocrinol Metab

Journal ID (iso-abbrev): Indian J Endocrinol Metab

Journal ID (publisher-id): IJEM

Title: Indian Journal of Endocrinology and Metabolism

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2230-8210

ISSN (Electronic): 2230-9500

Publication date (Print): Sep-Oct 2016

Volume: 20

Issue: 5

Pages: 720-724

Affiliations

[1] Department of Obstetrics, Bharti Hospital, Karnal, Haryana, India

[1 ] Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India

[2 ] Department of Obstetrics, All India Institute of Medical Sciences, New Delhi, India

Author notes

Corresponding Author: Dr. Sanjay Kalra, Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India. E-mail: brideknl@ 123456gmail.com

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Publisher ID: IJEM-20-720

DOI: 10.4103/2230-8210.189231

PMC ID: 5040057

PubMed ID: 27730087

SO-VID: 6231a53b-5f37-4139-9ea5-1413c8ae41b2

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The inositols and polycystic ovary syndrome

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Most cited references 23

D-chiro-inositol glycans in insulin signaling and insulin resistance.

Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.

Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS

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