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比较肌醇和二甲双胍对多囊卵巢综合征女性血糖控制、血脂谱以及与胰岛素和脂代谢相关基因表达的影响:一项随机对照临床试验。

Comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome: a randomized controlled clinical trial.

机构信息

a Department of Gynecology and Obstetrics, School of Medicine , Endocrinology and Metabolism Research Center, Arak University of Medical Sciences , Arak , Iran.

b Department of Gynecology and Obstetrics, School of Medicine , Kashan University of Medical Sciences , Kashan , Iran.

出版信息

Gynecol Endocrinol. 2019 May;35(5):406-411. doi: 10.1080/09513590.2018.1540570. Epub 2019 Jan 4.

Abstract

This investigation was conducted to evaluate comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome (PCOS). This randomized controlled trial was conducted on 53 women with PCOS, aged 18-40 years old. Subjects were randomly allocated into two groups to take either myo-inositol (n = 26) or metformin (n = 27) for 12 weeks. Myo-inositol supplementation, compared with metformin, significantly reduced fasting plasma glucose (FPG) (β -5.12 mg/dL; 95% CI, -8.09, -2.16; p=.001), serum insulin levels (β -1.49 µIU/mL; 95% CI, -2.28, -0.70; p<.001), homeostasis model of assessment-insulin resistance (β -0.36; 95% CI, -0.55, -0.17; p<.001), serum triglycerides (β 12.42 mg/dL; 95% CI, -20.47, -4.37; p=.003) and VLDL-cholesterol levels (β -2.48 mg/dL; 95% CI, -4.09, -0.87; p=.003), and significantly increased the quantitative insulin sensitivity check index (β 0.006; 95% CI, 0.002, 0.01; p=.006) compared with metformin. Moreover, myo-inositol supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p=.002) compared with metformin. Overall, taking myo-inositol, compared with metformin, for 12 weeks by women with PCOS had beneficial effects on glycemic control, triglycerides and VLDL-cholesterol levels, and gene expression of PPAR-γ.

摘要

这项研究旨在评估肌醇和二甲双胍对多囊卵巢综合征(PCOS)女性血糖控制、血脂谱以及与胰岛素和脂质代谢相关基因表达的影响。这是一项随机对照试验,共纳入 53 名年龄在 18-40 岁的 PCOS 女性。将受试者随机分为两组,分别服用肌醇(n=26)或二甲双胍(n=27),疗程为 12 周。与二甲双胍相比,肌醇补充治疗可显著降低空腹血糖(FPG)(β-5.12mg/dL;95%置信区间,-8.09,-2.16;p=.001)、血清胰岛素水平(β-1.49µIU/mL;95%置信区间,-2.28,-0.70;p<.001)、稳态模型评估的胰岛素抵抗指数(β-0.36;95%置信区间,-0.55,-0.17;p<.001)、血清三酰甘油(β12.42mg/dL;95%置信区间,-20.47,-4.37;p=.003)和极低密度脂蛋白胆固醇水平(β-2.48mg/dL;95%置信区间,-4.09,-0.87;p=.003),并显著提高了定量胰岛素敏感性检查指数(β0.006;95%置信区间,0.002,0.01;p=.006)。此外,与二甲双胍相比,肌醇补充治疗可上调过氧化物酶体增殖物激活受体γ(PPAR-γ)基因表达(p=.002)。总之,与二甲双胍相比,PCOS 女性服用肌醇 12 周对血糖控制、三酰甘油和极低密度脂蛋白胆固醇水平以及 PPAR-γ 基因表达具有有益影响。

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