Therapeutic potential of acarbose in ameliorating the metabolic and endocrinological complications of polycystic ovarian syndrome: a review

Abstract

Polycystic ovarian syndrome is a perplexed condition addressing endocrinal, cardiometabolic and gynaecological issues. It affects women of adolescent age and is drastically increasing in the Indo-Asian ethnicity over the recent years. According to Rotterdam criteria, PCOS is characterized by clinical or biochemical excess androgen and polycystic ovarian morphology; however, it has been established in the recent years that PCOS exacerbates to further serious metabolic conditions on the long term. This is a narrative literature review and not systematic review and is based on PubMed searches with relevant keywords “Polycystic ovarian syndrome AND acarbose OR metformin OR myoinositol; PCOS AND metabolic syndrome OR cardiovascular disease OR menstrual irregularity OR infertility OR chronic anovulation OR clinical hyperandrogenism” used in the title and are limited to articles published in English language with no time limits. A prominent aspect of PCOS is hyperandrogenaemia and hyperinsulinemia. About 50-70% of afflicted women have compensatory hyperinsulinemia and close to one tierce suffer from anovulation and infertility. Insulin resistance leads to metabolic complications and works with luteinizing hormone in increasing the ovarian androgen production. This excess androgen leads to clinical manifestations, irregular menstrual cycles and infertility. There isn’t an entire cure, only the symptomatic clinical factors are considered rather than focusing on the underlying long-term complications. Therefore, the article focuses on a potent alpha glucosidase inhibitor, acarbose which suppresses the post meal glucose and insulin by delaying the absorption of complex carbs. It exhibits cardio-metabolic and hormonal benefits and is well tolerable in the south asian population. This review highlights the safety, effectiveness of acarbose in ameliorating the long-term complications of PCOS.

Keywords:

• polycystic ovarian syndrome
• hyperinsulinemia
• hyperandrogenemia
• metabolic syndrome
• acarbose

Transparency

Declaration of funding

No funding was received for this study.

Declaration of financial/other relationships

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

R. Kamaraj researched the literature and conceived the idea of the review. Marina Andavar designed the review and collected, analysed the data and wrote the manuscript. T.M. Vijayakumar and M. Anuradha edited and critically revised the final manuscript. All the authors contributed to the development of the article and approved the submitted version.

Acknowledgements

None