Fruzzetti Franca, Benelli Elena, Fidecicchi Tiziana, Tonacchera Massimo
Department of Obstetrics and Gynecology, Pisa University Hospital, Pisa, Italy.
Department of Endocrinology, Pisa University Hospital, Pisa, Italy.
Int J Endocrinol. 2020 Mar 19;2020:2901393. doi: 10.1155/2020/2901393. eCollection 2020.
The aim of this retrospective study was to evaluate the effects of a treatment with -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%; < 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.
这项回顾性研究的目的是评估α-硫辛酸（ALA）联合两种不同剂量的肌醇（MI）治疗对多囊卵巢综合征（PCOS）女性临床和代谢特征的影响。88名女性接受了该治疗，其中71名有完整的临床记录并被认为符合本研究条件。所有女性均接受每天800mg的ALA治疗：43例患者每天接受2000mg的MI，28例患者每天接受1000mg的MI。在治疗6个月前后评估月经周期、体重指数（BMI）、促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇、睾酮、雄烯二酮、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA-IR）以及口服葡萄糖耐量试验（OGTT）2小时后的胰岛素反应。调查糖尿病亲属（DRs）的情况。71.2%的女性月经周期规律性得到改善。月经周期的改善与患者的胰岛素抵抗状态和DRs的存在无关。有胰岛素抵抗的女性主要表现为代谢参数的显著改善，而无胰岛素抵抗的女性生殖激素有显著变化。有DRs的患者治疗后未显示出显著变化。服用2000mg MI的女性中有85.7%报告月经规律性的改善高于服用1000mg MI的女性（50%；P<0.01）。总之，ALA+MI对PCOS女性的月经规律性有积极影响，无论其代谢表型如何，较高剂量的MI效果更明显。这种作用似乎与胰岛素无关。胰岛素抵抗的存在似乎是治疗后代谢状况改善的反应性预测指标。
