Endocrine and clinical aspects of inositol in polycystic ovarian syndrome
Polycystic ovary syndrome (PCOS) is characterized by hormonal changes that are commonly associated with insulin resistance. In this connection, the use of Myo-inositol (MYO) is an effective and promising treatment for PCOS, which demonstrates excellent therapeutic options without any significant side effects. The review summarizes current knowledge of the biological mechanisms of action of MYO and D-chiro-inositol, as well as the results of PCOS therapy.Dubrovina S.O., Krasilnikova L.V.
Keywords
polycystic ovary syndrome
insulin resistance
inositol
myo-inositol
D-chiro-inositol
References
- Orio F., Palomba S. Reproductive endocrinology: New guidelines for the diagnosis and treatment of PCOS. Nat. Rev. Endocrinol. 2014; 10(3): 130-2. https//dx.doi.org/10.1038/nrendo.2013.248.
- Genazzani A.D., Santagni S., Ricchieri F., Campedelli A., Rattighieri E., Chierchia E. et al. Myo-inositol modulates insulin and luteinizing hormone secretion in normal weight patients with polycystic ovary syndrome. J. Obstet. Gynaecol. Res. 2014; 40(5): 1353-60. https//dx.doi.org/10.1111/jog.12319.
- Genazzani A.D., Ricchieri F., Lanzoni C. Use of metformin in the treatment of polycystic ovary syndrome. Womens Health (Lond.). 2010; 6(4): 577-93. https//dx.doi.org/10.2217/whe.10.43.
- Sortino M.A., Salomone S., Carruba M.O., Drago F. Polycystic ovary syndrome: insights into the therapeutic approach with inositols. Front. Pharmacol. 2017; 8: 341. https//dx.doi.org/10.3389/fphar.2017.00341. eCollection 2017.
- Громова О.А., Торшин И.Ю., Гришина Т.Р., Громов А.Н., Лиманова О.А. Систематический анализ молекулярно-физиологических эффектов миоинозитола: данные молекулярной биологии, экспериментальной и клинической медицины. Эффективная фармакотерапия в акушерстве и гинекологии. 2013; 28: 4-12. [Gromova O.A., Torshin I.Yu., Grishina T.R., Gromov A.N., Limanova O.A. A systematic analysis of the molecular and physiological effects of myoinositol: data from molecular biology, experimental and clinical medicine. Effective pharmacotherapy in obstetrics and gynecology. 2013; 28: 4-12. (in Russian)]
- Lazarenko R., Geisler J., Bayliss D., Larner J., Li C. D-chiro-inositol glycan stimulates insulin secretion in pancreatic β cells. Mol. Cell. Endocrinol. 2014; 387(1-2): 1-7. https//dx.doi.org/10.1016/j.mce.2014.02.004.
- Formuso C., Stracquadanio M., Ciotta L. Myo-inositol vs. D-chiro inositol in PCOS treatment. Minerva Ginecol. 2015; 67(4): 321-5.
- Galazis N., Galazi M., Atiomo W. D-Chiro-inositol and its significance in polycystic ovary syndrome: a systematic review. Gynecol. Endocrinol. 2011; 27(4): 256-62. https//dx.doi.org/10.3109/09513590.2010.538099.
- Pizzo A., Laganà A.S., Barbaro L. Comparison between effects of myo-inositol and d-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecol. Endocrinol. 2014; 30(3): 205-8. https//dx.doi.org/10.3109/09513590.2013.860120.
- Artini P.G., Di Berardino O.M., Papini F., Genazzani A.D., Simi G., Ruggiero M., Cela V. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol. Endocrinol. 2013; 29(4): 375-9. https//dx.doi.org/10.3109/09513590.2012.743020.
- Morgante G., Orvieto R., Di Sabatino A., Musacchio M.C., De Leo V. The role of inositol supplementation in patients with polycystic ovary syndrome, with insulin resistance, undergoing the low-dose gonadotropin ovulation induction regimen. Fertil. Steril. 2011; 95(8): 2642-4. https//dx.doi.org/10.1016/j.fertnstert.2011.01.035.
- Raffone E., Rizzo P., Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol. Endocrinol. 2010; 26(4): 275-80.
- Вартанян Э.В., Цатурова К.А., Девятова Е.А., Михайлюкова А.С., Левин В.А., Петухова Н.Л., Маркин А.В., Степцова Е.М. Резервы улучшения качества ооцитов при синдроме поликистозных яичников. Проблемы репродукции. 2017; 23(3): 50-4. [Vartanyan E.V., Tsaturova K.A., Devyatova E.A., Mikhailyukova A.S., Levin V.A., Petukhova N.L., Markin A.V., Steptsova E.M. Reserves for improving the quality of oocytes in polycystic ovary syndrome. Reproduction problems. 2017; 23 (3): 50-4. (in Russian)] https//dx.doi.org/10.17116/repro201723350-54
- Громова О.А., Торшин И.Ю., Лиманова О.А. Перспективы использования миоинозитола у женщин с поликистозом яичников и инсулинорезистентностью в программах прегравидарной подготовки к экстракорпоральному оплодотворению. Эффективная фармакотерапия. 2013; 51: 12-23. [Gromova O.A., Torshin I.Yu., Limanova O.A. Prospects for the use of myo-inositol in women with polycystic ovaries and insulin resistance in pregravid preparation programs for extracorporeal fertilization. Effective pharmacotherapy. 2013; 51: 12-23. (in Russian)]
- Unfer V., Facchinetti F., Orrù B., Giordani B., Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr. Connect. 2017; 6(8): 647-58. https//dx.doi.org/10.1530/EC-17-0243.
- Genazzani A.D., Chierchia E., Rattighieri E., Santagni S., Casarosa E., Luisi M., Genazzani A.R. Metformin administration restores allopregnanolone response to adrenocorticotropic hormone(ACTH) stimulation in overweight hyperinsulinemic patients with PCOS. Gynecol. Endocrinol. 2010; 26(9): 684-9. https//dx.doi.org/10.3109/09513590.2010.500818.
- Genazzani A.D., Prati A., Santagni S., Ricchieri F., Chierchia E., Rattighieri E. et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol. Endocrinol. 2012; 28(12): 969-73. https//dx.doi.org/10.3109/09513590.2012.685205.
- Ciotta L., Stracquadanio M., Pagano I., Carbonaro A., Palumbo M., Gulino F. Effects of myo-inositol supplementation on oocyte’s quality in PCOS patients: a doubleblind trial. Eur. Rev. Med. Pharmacol. Sci. 2011; 15(5): 509-14.
- Unfer V., Carlomagno G., Dante G., Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol. Endocrinol. 2012; 28(7): 509-15. https//dx.doi.org/10.3109/09513590.2011.650660.
- Regidor P.A., Schindler A.E., Lesoine B., Druckman R. Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature. Horm. Mol. Biol. Clin. Investig. 2018; 34(2): pii: /j/hmbci.ahead-of-print/hmbci-2017-0067/hmbci-2017-0067.xml. https//dx.doi.org/10.1515/hmbci-2017-0067.
- Lisi F., Carfagna P., Oliva M.M., Rago R., Lisi R., Poverini R. et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod. Biol. Endocrinol. 2012; 10: 52. https//dx.doi.org/10.1186/1477-7827-10-52.
- Kamenov Z., Kolarov G., Gateva A., Carlomagno G., Genazzani A.D. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol. Endocrinol. 2015; 31(2): 131-5. https//dx.doi.org/10.3109/09513590.2014.964640.
- Carlomagno G., Unfer V. Inositol safety: clinical evidences. Eur. Rev. Med. Pharmacol. Sci. 2011; 15(8): 931-6.
- Werner E.F., Froehlich R.J. The potential role for myoinositol in the prevention of gestational diabetes mellitus. Am. J. Perinatol. 2016; 33(13): 1236-41. https//dx.doi.org/10.1055/s-0036-1584273.
- Corrado F., D’Anna R., Di Vieste G., Giordano D., Pintaudi B., Santamaria A., Di Benedetto A. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet. Med. 2011; 28(8): 972-5. https//dx.doi.org/10.1111/j.1464-5491.2011.03284.x
- Krapels I.P., Rooij I.A., Wevers R.A., Zielhuis G.A., Spauwen P.H., Brussel W., Steegers-Theunissen R.P. Myo-inositol, glucose and zinc status as risk factors for non-syndromic cleft lip with or without cleft palate in offspring: a case-control study. BJOG. 2004; 111(7): 661-8.
- Wdowiak A. Myoinositol improves embryo development in PCOS patients undergoing ICSI. Int. J. Endocrinol. 2016; 2016: 6273298.
- Regidor P.A., Schindler A.E. Myoinositolas a safe and alternative approach in the treatment of infertile PCOS women: A German Observational Study. Int. J. Endocrinol. 2016; 2016: 9537632. https//dx.doi.org/10.1155/2016/9537632.
Received 15.06.2018
Accepted 22.06.2018
About the Authors
Dubrovina, Svetlana O., MD, professor, the main scientific researcher, Rostov State Medical University, Ministry of Health of the Russian Federation, Rostov-on-Don, Russia. 344012, Russia, Rostov on Don, Mechnikova str. 43. Tel.: +78632504200. E-mail: s.dubrovina@gmail.comKrasilnikova, Liliya V., gynecologist, Medical Center «Centromed», Rostov-on-Don. 344000, Russia, Rostov on Don, 339th Rifle Division str. E-mail: cool.dalida2014@yandex.ru
For citations: Dubrovina S.O., Krasilnikova L.V. Endocrine and clinical aspects of inositol in polycystic ovarian syndrome. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (1): 150-3. (in Russian)
http://dx.doi.org/10.18565/aig.2019.1.150-153