Treatment with d-chiro-inositol and alpha lipoic acid in the management of polycystic ovary syndrome

Abstract

To evaluate the effects of the combination of d-chiro inositol and alpha lipoic acid on menstrual cycles and insulin sensitivity in women with polycystic ovary syndrome (PCOS). Forty-one women with PCOS and 31 controls have been enrolled in the study. The menstrual cycle, BMI, homeostasis model assessment index (HOMA-I), and insulin secretion in response to an OGTT were evaluated before and after 6 months of treatment. During the observation period, the patients have been asked to not modify their diet and physical activity. The menstrual cycle length improved in 76.7% of the women. Ovulation was restored in 40%. During treatment, BMI significantly decreased (p<.002). The HOMA-I and insulin secretion were unchanged by treatment. However, when women were divided according to the presence of insulin resistance (IR; HOMA-I > 2.5), in those with IR the HOMA-I and the insulin secretion significantly decreased (p<.05 and p<.006). The association of d-chiro-inositol and alpha lipoic acid improves menstrual cycle length, restoring ovulation in the majority of women. Insulin sensitivity improved in women with IR only, confirming that in presence of IR the d-chiro-inositol has a role in restoring the insulin action overcoming the inactivity of epimerase in transforming myo-inositol to d-chiro inositol.

摘要

为评估D-手性肌醇和α-硫辛酸联合应用对多囊卵巢综合征（PCOS）女性月经周期和胰岛素敏感性的效果。41名PCOS女性和31名对照女性参加了该研究。在治疗前和治疗6个月后, 月经周期、BMI、稳态模型胰岛素抵抗指数（HOMA-I）, 以及胰岛素分泌对OGTT试验的应答。在观察期间, 要求患者不改变其饮食和体育活动。月经周期长度在76.7%的女性中得到改善。排卵恢复率40%。治疗期间BMI显著下降（p<.002）。HOMA-I和胰岛素分泌未改变。但是, 将患者按照是否存在胰岛素抵抗（IR；HOMA-1 > 2.5）进行分组, 存在IR的患者中HOMA-I和胰岛素分泌显著降低（p<.05 和 p<.006）。D-手性肌醇和α-硫辛酸联合应用能够改善大多数女性月经周期长度、恢复排卵。胰岛素敏感性仅在IR女性中得到改善, 证实了存在IR时D-手性肌醇克服了差向异构酶在将肌醇转化为D-手性肌醇中的不活动性, 从而在恢复胰岛素功能中发挥作用。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Alpha lipoic acid
• PCOS
• amenorrhea
• d-chiro-inositol
• insulin resistance

Acknowledgements

The authors thank Sebastian Lucas for his valuable assistance in language revision.

Disclosure statement

The authors report no conflict of interest.