Department of Oncology and Hemato-oncology, Postgraduate School of Clinical Pharmacology, University of Milan, 20129 Milan, Italy.
Department of Neuroimmunology and Neuromuscular Diseases, Fondazione I.R.C.C.S., Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
Nutrients. 2020 Nov 3;12(11):3379. doi: 10.3390/nu12113379.
Liver lipid accumulation is a hallmark of non-alcoholic fatty liver disease (NAFLD), broadly associated with insulin resistance. Inositols (INS) are ubiquitous polyols implied in many physiological functions. They are produced endogenously, are present in many foods and in dietary supplements. Alterations in INS metabolism seems to play a role in diseases involving insulin resistance such as diabetes and polycystic ovary syndrome. Given its role in other metabolic syndromes, the hypothesis of an INS role as a supplement in NAFLD is intriguing. We performed a systematic review of the literature to find preclinical and clinical evidence of INS supplementation efficacy in NAFLD patients. We retrieved 10 studies on animal models assessing Myoinosiol or Pinitol deficiency or supplementation and one human randomized controlled trial (RCT). Overall, INS deficiency was associated with increased fatty liver in animals. Conversely, INS supplementation in animal models of fatty liver reduced hepatic triglycerides and cholesterol accumulation and maintained a normal ultrastructural liver histopathology. In the one included RCT, Pinitol supplementation obtained similar results. Pinitol significantly reduced liver fat, post-prandial triglycerides, AST levels, lipid peroxidation increasing glutathione peroxidase activity. These results, despite being limited, indicate the need for further evaluation of INS in NAFLD in larger clinical trials.
肝脏脂质堆积是非酒精性脂肪性肝病（NAFLD）的一个标志，与胰岛素抵抗广泛相关。肌醇（INS）是广泛存在的多元醇，涉及许多生理功能。它们在体内产生，存在于许多食物和膳食补充剂中。INS 代谢的改变似乎在涉及胰岛素抵抗的疾病中发挥作用，如糖尿病和多囊卵巢综合征。鉴于其在其他代谢综合征中的作用，INS 作为 NAFLD 补充剂的假设很有趣。我们对文献进行了系统回顾，以寻找 INS 补充剂在 NAFLD 患者中的临床前和临床证据。我们检索了 10 项关于动物模型评估 Myoinosiol 或 Pinitol 缺乏或补充的研究和一项人类随机对照试验（RCT）。总体而言，INS 缺乏与动物脂肪肝的增加有关。相反，INS 补充剂在脂肪肝动物模型中可减少肝甘油三酯和胆固醇的积累，并维持正常的超微结构肝组织病理学。在纳入的 RCT 中，Pinitol 补充剂获得了类似的结果。Pinitol 可显著降低肝脏脂肪、餐后甘油三酯、AST 水平、脂质过氧化增加谷胱甘肽过氧化物酶活性。尽管这些结果有限，但表明需要在更大的临床试验中进一步评估 INS 在 NAFLD 中的作用。
