Comparative effectiveness of four therapeutic strategies in overweight adolescents aged 12–18 with polycystic ovary syndrome: the INO-TEEN prospective study
Panshina M.V., Khabarov S.V., Uvarova E.V., Nagaeva E.V., Levin V.A., Sharifullina E.R., Di Renzo G.C., Montanino Oliva M.
Objective. To conduct a comparative analysis of the effectiveness of four therapeutic strategies: combined oral contraceptives (COCs), myo-inositol [α-LA + MI, Inofert Forte], their combination (COC + [α-LA + MI, Inofert Forte]) and lifestyle modification in overweight adolescents aged 12–18 with polycystic ovary syndrome (PCOS), and to identify age-related differences in response to the therapy.
Materials and methods. 180 adolescents with PCOS were included in the study and divided into three age groups (12–13, 14–16, and 17–18 years). In each age group patients were randomized into four subgroups (60 people in each) depending on the assigned treatment (COC, α-LA+MI, COC+[α-LA+MI], lifestyle modification). Anthropometric, metabolic, and hormonal parameters were assessed. In the lifestyle modification and α-LA+MI groups, the regularity of the menstrual cycle and restoration of ovulation were also analyzed.
Results. Patient groups with lifestyle modification and α-LA+MI (Inofert Forte) demonstrated the most significant improvement in metabolic parameters (a decrease in HOMA-IR by 22–44%, p<0.001). COCs and
COCs+[α-LA+MI, Inofert Forte] provided the most significant decrease in testosterone levels (by 38–45%, p<0.001) and LH/FSH (p<0.001), and α-LA+MI (Inofert Forte) was the most effective in restoring a regular menstrual cycle (up to 93%) compared to lifestyle modification strategy. The latter resulted in the most significant reduction in BMI (by 2.1–2.6 kg/m²; p<0.001). Age turned put to be a significant contributing factor of response to the therapy, with older adolescents demonstrating greater improvement in both metabolic and hormonal parameters.
Conclusion. The choice of the best therapy in overweight adolescents with PCOS should take into account both metabolic status and the patient's age. COC+ [α-LA+MI, Inofert Forte, Italfarmaco] represent a balanced strategy that combines a marked hormonal effect and acceptable metabolic safety. α-LA+MI and lifestyle modification strategy are especially effective in severe insulin resistance.
Authors’ contributions. Panshina M.V., Khabarov S.V., Uvarova E.V., Nagaeva E.V., Levin V.A., Sharifullina E.R., Di Renzo G.C., Montanino Oliva M. – study concept and design, data collection and processing, manuscript writing, editing, approval of the final version for publication.
Conflicts of interest. The authors declare no conflicts of interest.
Funding. The study had no sponsorship support.
Ethical Approval. The study was approved by the Bioethics Committee of the Medical Institute of the Tula State University (protocol №5 as of December 19, 2024).
Use of generative artificial intelligence. No AI was used.
Patient Consent for Publication. All patients signed voluntary 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: Panshina M.V., Khabarov S.V., Uvarova E.V., Nagaeva E.V., Levin V.A., Sharifullina E.R., Di Renzo G.C., Montanino Oliva M. Comparative effectiveness of four therapeutic strategies in overweight adolescents aged 12–18 with polycystic ovary syndrome: the INO-TEEN prospective study.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (5): 148-156 (in Russian)
https://dx.doi.org/10.18565/aig.2026.124
Keywords
polycystic ovary syndrome
adolescents
myo-inositol
combined oral contraceptives
lifestyle modification
insulin resistance
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Received 17.04.2026
Accepted 06.05.2026
About the Authors
Maria V. Panshina, PhD, Associate Professor at the Department of Obstetrics and Gynecology of Medical Institute, Tula State University, 128 Boldin str., Tula, 300028, Russia, +7(910)912-85-68, masha_doctor@bk.ru, https://orcid.org/0000-0002-5221-1761Sergey V. Khabarov, Dr. Med. Sci., Merited Doctor of the Russian Federation, Associate Professor, Professor at the Department of Obstetrics and Gynecology of Medical Institute, Tula State University, 128 Boldin str., Tula, 300028, Russia; Professor at the Department of Clinical Laboratory Diagnostics and Pathological Anatomy,
Academy of Postgraduate Education of the FMBA; Chief Physician, VitroClinic, +7(916)726-51-26, s.v.habarov@mail.ru, https://orcid.org/0000-0002-1736-9408
Elena V. Uvarova, Corresponding Member of RAS, Dr. Med. Sci., Professor, Head of the 2nd Gynecological Department (Gynecology of Children and Adolescents), V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4; Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology of IPE, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2; President of the Interregional Public Organization «Association of Children and Adolescent Gynecologists»; chief freelance gynecologist of children and adolescents of the Ministry of Health of Russia, elena-uvarova@yandex.ru, https://orcid.org/0000-0002-3105-5640
Elena V. Nagaeva, Dr. Med. Sci., Professor at the Department of Pediatric Endocrinology-Diabetology, Head of the Department of Thyroidology, Reproductive and Somatic Development, Institute of Pediatric Endocrinology, Academician I.I. Dedov National Medical Research Center of Endocrinology, Ministry of Health of Russia,
117292, Russia, Moscow, Dm. Ulyanova str., 11, nagaeva.elena@endocrincentr.ru, SPIN-code: 4878-7810, https://orcid.org/0000-0001-6429-7198
Vitaly A. Levin, Endocrinologist, Specialist in Health Management and Public Health, Ornament Health AG, Lucerne, Switzerland, https://orcid.org/0009-0000-8758-0842
Elina R. Sharifullina, Endocrinologist, PhD in Neuroscience (Neurodegenerative disorders), International School for Advanced Studies (SISSA/ISAS), Trieste, Italy.
Gian Carlo Di Renzo, MD, PhD, FRCOG (hon) FACOG (hon) FICOG (hon), Professor of Obstetrics, Maternal-Fetal Medicine and Gynecology; Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia; past chair, Department of Obstetrics and Gynecology, University of Perugia, Italy; past General Secretary, FIGO; Director, the Alliance for Global Women’s Medicine (GLOWM) London, UK; Co-President, the New European Surgery Academy (NESA), Berlin, Germany; Director, PREIS School (The Permanent International and European School of Perinatal, Neonatal and Reproductive Medicine), Florence, Italy; Hon President Asia Pacific Health Association (Pediatric-Neonatology Branch), Beijing, PR China, profgcdr@gmail.com, www.giancarlodirenzo.com
Mario Montanino Oliva, MD, PhD, Professor, Scientific Consultant in Obstetrics and Gynecology, Clinic Santo-Spirito, Rome, Italy, https://orcid.org/0000-0001-8676-1465
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