Randomised controlled trial comparing Myo-inositol with Metformin in patients with polycystic ovary syndrome

Randomised controlled trial comparing Myo-inositol with Metformin in patients with polycystic ovary syndrome

Registration ID: IJNRD_210608

Published ID: IJNRD2312392

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S. Ramya , S. Swarnalatha , R. Rajesh , S. Priyanka , S. Deepika

PCOS, Myo-inositol, Metformin, Insulin Resistance

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women of reproductive age group affecting approximately, 4 – 15 % of female population. PCOD is no longer disorder confined to ovary, but involves a complex pathophysiology of multiple organs like hypothalamus, pituitary, adrenals and adipose tissue. Environmental factors like stress, life style changes including increased fat, carbohydrate diet and reduced physical activity are important contributing factors. Genetic factors include mutations in genes coding for CYP450 enzymes like CYP 11A1, CYP 21A1 and defects in enzymes involved in cholesterol metabolism and androgen synthesis. Diagnosis is based on consensus oligo / anovulation, hyperandrogenism, polycystic ovaries, with exclusion of other endocrine disorders. Anovulation in PCOS is due to inappropriate gonadotropin secretion. This leads to preferential production of luteinizing hormone (LH) compared to follicle stimulating hormone (FSH) and LH:FSH ratio becomes 2:1 or even 3:14. Insulin resistance is common in approximately 60 – 70% of women with PCOS. IR is reduced response of peripheral tissues to insulin. It is due to phosphorylation of serine residues of insulin receptor leading to post binding abnormality in receptor mediated signal transduction. IR is sensed by pancreas as insulin deficiency and leads to compensatory hyperinsulinemia. This excess insulin stimulates luteinizing hormone (LH) to produce more androgens from theca cells of ovary leading to features of hyperandrogenism. Increased androgens, prevent maturation of one dominant follicle as Graafian follicle and also prevent apoptosis of small follicles, which are normally destined to disappear. This gives the appearance of polycystic ovaries in ultrasound as necklace like pattern in the peripheral rim of ovary. In addition, life style modifications like regular exercise and balanced diet are the first line management. Insulin sensitizers like metformin are used to avoid and treat metabolic disorders associated with IR such as diabetes, dyslipidemia and cardiovascular events. But this is associated with gastrointestinal adverse effects like nausea, diarrhea, dyspepsia, flatulence and abdomen pain. This leads to poor patient compliance. Inositol is a polyalcohol, a physiological compound of sugar family of which two stereoisomers are found in our body, Myo-inositol (MI) and D-chiro inositol (DCI). MI is very scarce in diet and synthesized endogenously from Myo inositol by insulin dependent epimerase enzyme. D-chiro-inositol is an important second messenger in insulin signal transduction. It acts as a precursor for inositol triphosphate (IP3) and phosphatidyl inositol 3 kinase (PI3K), needed for actions of insulin like increased glucose uptake, thus improving insulin sensitivity. Thus, MI can be used as an alternative to metformin to improve insulin sensitivity. Certain studies have demonstrated the efficacy of MI in reducing metabolic and endocrinological abnormalities in PCOS patient. This study was undertaken to demonstrate the efficacy and safety of Myo-inositol, since limited studies are available in India regarding supplementation of Myo-inositol in PCOS.

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"Randomised controlled trial comparing Myo-inositol with Metformin in patients with polycystic ovary syndrome ", IJNRD - INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT (www.IJNRD.org), ISSN:2456-4184, Vol.8, Issue 12, page no.d836-d845, December-2023, Available :https://ijnrd.org/papers/IJNRD2312392.pdf

Volume 8 Issue 12, December-2023

Pages : d836-d845

Paper Reg. ID: IJNRD_210608

Published Paper Id: IJNRD2312392

Downloads: 000121209

Research Area: Pharmacy

Country: Chennai, Tamil Nadu, India

Published Paper PDF: https://ijnrd.org/papers/IJNRD2312392.pdf

Published Paper URL: https://ijnrd.org/viewpaperforall?paper=IJNRD2312392

Journal Name: INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT(IJNRD)

ISSN: 2456-4184 | IMPACT FACTOR: 8.76 Calculated By Google Scholar | ESTD YEAR: 2016

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