Inositol and lipoic acid in the treatment of insulin resistance in women with polycystic ovary syndrome
- 作者: Pustotina O.A.1
-
隶属关系:
- F.I. Inozemtsev Academy of Medical Education
- 期: 编号 12 (2020)
- 页面: 209-216
- 栏目: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249214
- DOI: https://doi.org/10.18565/aig.2020.12.209-216
- ID: 249214
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详细
Insulin resistance (IR) is a trigger for most pathogenetic changes in polycystic ovary syndrome (PCOS). The inositol stereoisomers myo-inositol (MI) and D-chiro-inositol (DCI) are actively involved in showing insulin effects. The MI/DCI ratio varies with tissue metabolic requirements and is under strict control with insulin. The MI/DCI ratio in plasma is 40:1, whereas that in follicular fluid is 100:1. In women with PCOS and IR, the concentration of DCI in insulin-sensitive tissues (muscles, brain, heart, adipose tissue) decreases drastically, which may be due to both a lack of total consumption of inositol and impaired expression/synthesis of epimerase that converts MI into DCI. The ovaries, on the other hand, respond to excess insulin by over-epimerization of MI in DCI and by a decrease in the MI/DCI ratio in follicular fluid to 0.2:1. Experimental and clinical studies have shown that MI in combination with DCI in the 40:1 ratio corresponding to the physiological content in blood plasma is the most optimal therapeutic regimen to reverse metabolic, hormonal, and reproductive disorders in women with PCOS. Regulation of glucose metabolism also occurs independently of inositol with endogenous alpha-lipoic acid (ALA) synthesized in the mitochondria. Conclusion. Supplementation of ALA with inositol improves insulin sensitivity and reproductive function in women with PC OS, especially in those with obesity and a genetic predisposition to diabetes mellitus. Thus, ALA in combination with MI and DCI creates a new comprehensive strategy for overcoming IR and its sequels in women with PCOS.
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作者简介
Olga Pustotina
F.I. Inozemtsev Academy of Medical Education
Email: pustotina@gmail.com
Dr. Med. Sci., Professor of the Department of obstetrics and gynecology with a course in reproductive medicine
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