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      Effects of L-carnitine on Polycystic Ovary Syndrome

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          Abstract

          Objective:

          Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age. This study investigated the effects of L-carnitine on the clinical and laboratory findings of women with PCOS.

          Methods:

          Eighty women diagnosed with PCOS between 2017 and 2018 by the Rotterdam Criteria were enrolled in the study; six were lost during the study. The participants were given L-carnitine 3 g daily (Pursinapharma, Iran) for three months. Blood samples were taken after overnight fasting at baseline and three months into the study to assess the levels of fasting glucose, insulin, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), free testosterone, dehydroepiandrosterone (DHEA), and the insulin resistance index (HOMA-IR). The patients were weighed before and after treatment and had their body mass index (BMI) calculated. Menstrual cycles and manifestations of hirsutism were also assessed.

          Results:

          The data showed a significant improvement in insulin sensitivity and decreases in serum LDL levels and the BMI after three months of treatment. There was a significant increase in serum HDL levels. More regular menstrual cycles and decreased hirsutism were also observed.

          Conclusion:

          It appears that treatment with L-carnitine might decrease the risk of cardiovascular events by normalizing metabolic profiles and the BMI.

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          Most cited references 27

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          Carnitine: a nutritional, biosynthetic, and functional perspective.

          Carnitine status in humans is reported to vary according to body composition, gender, and diet. Plasma carnitine concentration positively correlates with the dietary intake of carnitine. The content of carnitine in foodstuff is based on old and inadequate methodology. Nevertheless, dietary carnitine is important. The molecular biology of the enzymes of carnitine biosynthesis has recently been accomplished. Carnitine biosynthesis requires pathways in different tissues and is an efficient system. Overall biosynthesis is determined by the availability of trimethyllysine from tissue proteins. Carnitine deficiency resulting from a defect in biosynthesis has yet to be reported. The role of carnitine in long-chain fatty acid oxidation is well defined. Recent evidence supports a role for the voltage-dependent anion channel in the transport of acyl-CoAs through the mitochondrial outer membrane. The mitochondrial outer membrane carnitine palmitoyltransferase-I in liver can be phosphorylated and when phosphorylated the sensitivity to malonyl-CoA is greatly decreased. This may explain the change in sensitivity of liver carnitine palmitoyltransferase-I observed during fasting and diabetes. Recently reported data clarify the role of carnitine and the carnitine transport system in the interplay between peroxisomes and mitochondrial fatty acid oxidation. Lastly, the buffering of the acyl-CoA/CoA coupled by carnitine reflects intracellular metabolism. This mass action effect underlies the use of carnitine as a therapeutic agent. In summary, these new observations help to further our understanding of the molecular aspects of carnitine in medicine.
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            Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.

            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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              Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study.

              To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of polycystic ovary syndrome (PCOS) patients.
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                Author and article information

                Journal
                JBRA Assist Reprod
                JBRA Assist Reprod
                jbra
                JBRA Assisted Reproduction
                Brazilian Society of Assisted Reproduction
                1517-5693
                1518-0557
                Oct-Dec 2019
                Oct-Dec 2019
                : 23
                : 4
                : 392-395
                Affiliations
                [1 ] Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding author: Leila Nazari, Department of Obstetrics and Gynecology IVF center, Taleghani Hospital, Velenjak St, Chamran Highway, Tehran, Iran. Email: nazari@ 123456sbmu.ac.ir
                Article
                10.5935/1518-0557.20190033
                6798588
                31294953

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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