Abstract
The aim of this retrospective study was to evaluate the effects of a treatment with α-lipoic acid (ALA) associated with two different doses of myo-inositol (MI) on clinical and metabolic features of women with polycystic ovary syndrome (PCOS). Eighty-eight women received the treatment, and 71 among them had complete clinical charts and were considered eligible for this study. All women were treated with 800 mg of ALA per day: 43 patients received 2000 mg of MI and 28 received 1000 mg of MI per day. Menstrual cyclicity, BMI, FSH, LH, estradiol, testosterone, androstenedione, fasting insulin, HOMA-IR, and insulin response to a 2 h OGTT were evaluated before and after 6 months of treatment. The presence of diabetic relatives (DRs) was investigated. Cycle regularity was improved in 71.2% of women. The improvement of menstrual cyclicity occurred regardless of the state of IR and the presence of DRs of the patients. Women with IR mainly showed a significant improvement of metabolic parameters, while those without IR had significant changes of reproductive hormones. Patients with DRs did not show significant changes after the treatment. 85.7% of women taking 2000 mg of MI reported a higher improvement of menstrual regularity than those taking 1000 mg of MI (50%; p < 0.01). In conclusion, ALA + MI positively affects the menstrual regularity of women with PCOS, regardless of their metabolic phenotype, with a more evident effect with a higher dose of MI. This effect seems to be insulin independent. The presence of IR seems to be a predictor of responsivity to the treatment in terms of an improvement of the metabolic profile.
Highlights
Polycystic ovary syndrome (PCOS) is a very common endocrine disease of the reproductive age that is defined by the modified Rotterdam criteria of 2003 as the presence of at least two of the following: clinical or biochemical signs of hyperandrogenism, chronic anovulation, and polycystic ovary morphology [1]
Insulin interaction with its receptor can activate this transduction pathway mediated by inositols, bringing the constitution of intracellular messengers that are involved in glucose oxidative metabolism instead of nonoxidative metabolism. e MI-inositol phosphoglycan (IPG) can reduce insulin resistance (IR) and improve glucose metabolism [9]
We studied the changes of reproductive, androgenic, and metabolic parameters of PCOS women after 6 months of treatment with 800 mg of a treatment with α-lipoic acid (ALA) per day combined with MI, subsequently evaluating if the presence of IR and/or of familiarity for type 2 diabetes mellitus influenced the results. en, we investigated if the same dose of ALA (800 mg) elicits different results when associated with different doses of MI (1000 mg or 2000 mg per day)
Summary
Polycystic ovary syndrome (PCOS) is a very common endocrine disease of the reproductive age that is defined by the modified Rotterdam criteria of 2003 as the presence of at least two of the following: clinical or biochemical signs of hyperandrogenism, chronic anovulation, and polycystic ovary morphology [1] Beside these criteria, the metabolic pattern of women with PCOS is a very important feature of the syndrome [2, 3]. MI supplementation at the dose of 2–4 g has shown to be effective in ameliorating both metabolic and reproductive features in PCOS women, reducing insulin plasma levels and IR, and improving the oocyte quality and menstrual cycle [8, 18,19,20,21]. We studied the changes of reproductive, androgenic, and metabolic parameters of PCOS women after 6 months of treatment with 800 mg of ALA per day combined with MI, subsequently evaluating if the presence of IR and/or of familiarity for type 2 diabetes mellitus influenced the results. en, we investigated if the same dose of ALA (800 mg) elicits different results when associated with different doses of MI (1000 mg or 2000 mg per day)
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