Genazzani Alessandro D
Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy.
Reprod Biomed Online. 2016 Dec;33(6):770-780. doi: 10.1016/j.rbmo.2016.08.024. Epub 2016 Sep 16.
Studies over the last decade have demonstrated that some polycystic ovary syndrome (PCOS) patients have abnormal insulin sensitivity (insulin resistance), independently from being overweight or obese. This induces the risk of developing type 2 diabetes in such PCOS patients. The use of insulin sensitizers (i.e. metformin), reduces such metabolic, and most hormonal, impairments. As metformin often induces side effects, new integrative strategies have been proposed to treat insulin resistance, such as the use of inositols. Such compounds are mainly represented in humans by two inositol stereoisomers: myo-inositol (MYO) and d-chiro-inositol (DCI). MYO is the precursor of inositol triphosphate, a second messenger that regulates thyroid-stimulating hormone (TSH) and FSH as well as insulin. DCI derives from the conversion of myo-inositol via an insulin-dependent pathway. Several preliminary studies have indicated possible benefits of inositol therapy in PCOS patients, but to date no meta-analysis has been performed. This review aims to give clinical insights for the clinical use of inositol in PCOS.
过去十年的研究表明，一些多囊卵巢综合征（PCOS）患者存在异常的胰岛素敏感性（胰岛素抵抗），这与体重超重或肥胖无关。这增加了此类PCOS患者患2型糖尿病的风险。使用胰岛素增敏剂（即二甲双胍）可减轻此类代谢和大多数激素方面的损害。由于二甲双胍常引起副作用，因此人们提出了新的综合策略来治疗胰岛素抵抗，如使用肌醇。此类化合物在人体内主要由两种肌醇立体异构体代表：肌醇（MYO）和D-手性肌醇（DCI）。MYO是三磷酸肌醇的前体，三磷酸肌醇是一种调节促甲状腺激素（TSH）、促卵泡激素（FSH）以及胰岛素的第二信使。DCI通过胰岛素依赖途径由肌醇转化而来。几项初步研究表明肌醇治疗对PCOS患者可能有益，但迄今为止尚未进行荟萃分析。本综述旨在为肌醇在PCOS临床应用中提供临床见解。
