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

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Abstract

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.

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About the authors

Olga A. Pustotina

F.I. Inozemtsev Academy of Medical Education

Author for correspondence.
Email: pustotina@gmail.com
ORCID iD: 0000-0001-6117-7270

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology with a Course in Reproductive Medicine

Russian Federation, St. Petersburg

Irina A. Rasulova

H-Clinic LLC

Email: irisha.harmony@gmail.com

Obstetrician-Gynecologist

Russian Federation, Moscow

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2. Figure. Dynamics of hormonal and metabolic parameters after 3 months of MI and DHI 40:1 combination administration

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