The effect of myoinositol and D-chiroinositol in a ratio of 40:1 on hormonal and metabolic parameters in women with polycystic ovary syndrome

Pustotina О.А., Rasulova I.A.

1) F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; 2) H-Clinic LLC, Moscow, Russia
Background: Insulin resistance (IR) and compensatory hyperinsulinemia are considered to trigger pathogenetic changes in women with polycystic ovary syndrome (PCOS); however, insulin-sensitizing therapy shows contradictory results. Objective: To evaluate the incidence of metabolic disorders in patients with PCOS and the effect of a combination of myoinositol (MI) and D-chiroinositol (DHI) in a ratio of 40:1 on hormonal and metabolic parameters. Materials and methods: This was an open prospective study including 34 patients with the classic PCOS phenotype who received 2255 mg of inositol per day for 3 months (MI and DHI in a ratio of 40:1). Serum levels of follicle-stimulating hormone, luteinizing hormone (LH), estradiol, total and free testosterone, sex hormone binding globulin (SHBG), anti-Mullerian hormone, glucose, insulin, HOMA-IR index and body mass index (BMI) were evaluated before and after administration. Results: The classic PCOS phenotype is associated with a high incidence of metabolic disorders: 55.9% of the examined women were overweight or obese, 50% had IR, 17.6% had a history of gestational diabetes mellitus, 61.8% had a family history of type 2 diabetes mellitus. After 3 months of taking a combination of MI and DHI in a ratio of 40:1, the parameters significantly decreased, namely, BMI (p=0.0029) and IR index (p=0.0007); the number of patients with elevated insulin levels in the blood decreased by 2.4 times. There was an improvement in markers of ovarian steroidogenesis: the serum level of total testosterone decreased (1.51±0.52 vs. 2.02±0.73 nmol/L, p<0.0001), free testosterone reduced (2.0 (1.0; 2.5) vs. 2.9 (1.6; 4.5) pg/ml, p=0.0002) and LH decreased (6.03±2.12 vs. 7.10±2.66 mME/ml, p=0.0058); concentrations of SHBG (69.15±21.66 vs. 40.78±22.66 nmol/L, p<0.0001) and estradiol (190 (150; 316) vs. 148 (111; 286) pmol/L, p=0.0003) increased. Conclusion: The combined administration of MI and DCI in a ratio of 40:1 improves metabolic and hormonal parameters in patients with the classic PCOS phenotype. Authors’ contributions: Pustotina O.A. – collecting the clinical data and creating an electronic database of the obtained results, analyzing the results of statistical processing of clinical material and their interpretation, writing, correcting and editing the article before submitting it for publication; Rasulova I.A. – collecting the clinical data and creating an electronic database of the obtained results, approval of the final version of the article before submitting it for publication. Conflicts of interest: The authors declare no possible conflicts of interest and guarantee that the article is the original work of the authors. Funding: The development and conducting of the study, the collection, analysis and interpretation of the data, as well as the preparation, review and approval of the manuscript were not sponsored. Ethical Approval: The study was approved by the Ethical Review Board of the F.I. Inozemtsev Academy of Medical Education (Protocol No.1 – 21/01/2022). Patient Consent for Publication: All patients signed an informed consent for the publication of their data. Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator. For citation: Pustotina О.А., Rasulova I.A. The effect of myoinositol and D-chiroinositol in a ratio of 40:1 on hormonal and metabolic parameters in women with polycystic ovary syndrome. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (9): 170-178 (in Russian)


polycystic ovary syndrome
insulin resistance


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Received 23.08.2023

Accepted 05.09.2023

About the Authors

Olga A. Pustotina, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology with a course in reproductive medicine, F.I. Inozemtsev Academy of Medical Education, +7(916)926-76-52,,, 190013, Russia, St. Petersburg, Moskovsky Ave., 22M, office N.
Irina A. Rasulova, obstetrician-gynecologist, H-Clinic LLC, +7(916)354-43-25,, 127083. Russia, Moscow, March 8 str., 6A-1.

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