Davinelli Sergio, Nicolosi Daria, Di Cesare Cinzia, Scapagnini Giovanni, Di Marco Roberto
Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.
J Clin Med. 2020 Apr 2;9(4):987. doi: 10.3390/jcm9040987.
Polycystic ovary syndrome (PCOS) is a complex disorder associated with ovarian dysfunction, infertility, menstrual irregularity, and hormonal impairments. Over the last decade, several studies have shown that some PCOS women have insulin resistance (InsR) and hyperinsulinemia, apart from being overweight or obese. Therefore, a crucial clinical aspect is that PCOS patients might develop glucose intolerance and type 2 diabetes. Insulin-sensitizing drugs have been used as first-line treatment to improve hyperinsulinemia in women with PCOS. Although reducing PCOS symptoms and signs, several used insulin-sensitizer drugs may induce side effects, which reduces compliance. D-chiro-inositol (DCI), which is a naturally occurring stereoisomer of inositol, has been classified as an insulin-sensitizer and seems to mitigate multiple InsR-related metabolic alterations in PCOS with a safe profile. However, according to a multi-targeted design, the supplementation with DCI can be synergistically integrated by combining other potential insulin-sensitizing drugs and/or nutraceuticals. The literature provides the initial support for using several unexplored nutraceutical interventions that may target relevant metabolic abnormalities associated with InsR in PCOS. With a need to promote interest in clinical research, this review aims to discuss the efficacy of DCI and the role of emerging nutraceuticals for managing InsR in PCOS.
多囊卵巢综合征（PCOS）是一种复杂的疾病，与卵巢功能障碍、不孕、月经不规律和激素紊乱有关。在过去十年中，多项研究表明，一些PCOS女性除了超重或肥胖外，还存在胰岛素抵抗（InsR）和高胰岛素血症。因此，一个关键的临床问题是PCOS患者可能会发展为葡萄糖耐量异常和2型糖尿病。胰岛素增敏药物已被用作一线治疗药物，以改善PCOS女性的高胰岛素血症。尽管一些常用的胰岛素增敏药物可以减轻PCOS的症状和体征，但它们可能会引起副作用，从而降低患者的依从性。D-手性肌醇（DCI）是一种天然存在的肌醇立体异构体，已被归类为胰岛素增敏剂，似乎可以减轻PCOS中多种与InsR相关的代谢改变，且安全性良好。然而，根据多靶点设计，补充DCI可以与其他潜在的胰岛素增敏药物和/或营养保健品协同整合。文献为使用几种未探索的营养保健品干预措施提供了初步支持，这些措施可能针对PCOS中与InsR相关的相关代谢异常。为了促进对临床研究的兴趣，本综述旨在讨论DCI的疗效以及新兴营养保健品在管理PCOS患者InsR方面的作用。
