He Jing, Zhang Yan-Li, Wang Li-Ping, Liu Xiao-Chun
Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan 030032, Shanxi Province, China.
World J Clin Cases. 2021 Jan 26;9(3):565-572. doi: 10.12998/wjcc.v9.i3.565.
Inositol is a hexa-carbon polyol, a naturally soluble vitamin, often found in various foods.
To discuss the impact of different stereoisomers of inositol on insulin sensitivity of gestational diabetes mellitus (GDM) patients.
Eighty GDM pregnant women were divided into four groups according to their treatment received: A group (placebo folic acid 400 μg/d), B group [myo-inositol (MI) 1500 mg, twice a day], C group [D-chiro-inositol (DCI) 250 mg, twice a day], and D group (inositol MI and inositol DCI 1500 mg/250 mg, twice a day). Each patient routinely used dietary guidance adjustments and did some safe and effective aerobic exercise in addition to receiving placebo or inositol from GDM diagnosis to delivery. Triglyceride, total cholesterol, fasting plasma glucose, oral glucose tolerance test postprandial glucose (2 h postprandial blood glucose), fasting insulin, fasting plasma glucose, and glycosylated hemoglobin levels and Homeostasis Model Assessment-insulin resistance (HOMA-IR) and Homeostasis Model Assessment-insulin sensitivity index (HOMA-ISI) scores were determined before treatment and 8 wk after treatment onset. Adverse maternal and infant outcomes, including hypoglycemia, excessive amniotic fluid, premature infants, macrosomia, fetal distress ., were also recorded.
There was no statistical difference in the baseline data of each group. The levels of 2 h blood glucose, glycosylated hemoglobin, fasting insulin, total cholesterol, and triglyceride in the B, C, and D groups were significantly lower than those in the control group (A group) after treatment ( < 0.05). Moreover, compared with the B group, the level of the above indexes in the C and D groups decreased more significantly, and the differences were statistically significant ( < 0.05). The HOMA-IR of B, C, and D groups decreased significantly, and the HOMA-ISI increased significantly compared with the A group, and the differences were statistically significant ( < 0.05), among which the decrease of HOMA-IR and the increase of HOMA-ISI were more significant in the C and D group compared with the B group ( < 0.05). The occurrence rate of adverse maternal and infant outcomes in the C and D group was significantly lower than that in the control group (A group), and the differences were statistically significant ( < 0.05).
Treatment with different inositol stereoisomers (inositol MI and inositol DCI) can improve insulin sensitivity and reduce insulin resistance in diabetic patients, and inositol DCI has a better curative effect than inositol MI.
肌醇是一种六碳多元醇，是一种天然可溶的维生素，常见于各种食物中。
探讨肌醇不同立体异构体对妊娠期糖尿病（GDM）患者胰岛素敏感性的影响。
80例GDM孕妇根据接受的治疗分为四组：A组（安慰剂叶酸400μg/d），B组[肌醇（MI）1500mg，每日2次]，C组[D-手性肌醇（DCI）250mg，每日2次]，D组（肌醇MI和肌醇DCI 1500mg/ 250mg，每日2次）。从GDM诊断到分娩，每位患者除接受安慰剂或肌醇外，还常规进行饮食指导调整并进行一些安全有效的有氧运动。在治疗前和治疗开始8周后测定甘油三酯、总胆固醇、空腹血糖、口服葡萄糖耐量试验餐后血糖（餐后2小时血糖）、空腹胰岛素、空腹血糖、糖化血红蛋白水平以及稳态模型评估胰岛素抵抗（HOMA-IR）和稳态模型评估胰岛素敏感性指数（HOMA-ISI）评分。还记录了母婴不良结局，包括低血糖、羊水过多、早产、巨大儿、胎儿窘迫等。
各组基线数据无统计学差异。治疗后B、C、D组2小时血糖、糖化血红蛋白、空腹胰岛素、总胆固醇和甘油三酯水平均显著低于对照组（A组）（P<0.05）。此外，与B组相比，C组和D组上述指标水平下降更显著，差异有统计学意义（P<0.05）。与A组相比，B、C、D组HOMA-IR显著降低，HOMA-ISI显著升高，差异有统计学意义（P<0.05），其中C组和D组HOMA-IR降低及HOMA-ISI升高较B组更显著（P<0.05）。C组和D组母婴不良结局发生率显著低于对照组（A组），差异有统计学意义（P<0.05）。
不同肌醇立体异构体（肌醇MI和肌醇DCI）治疗可提高糖尿病患者胰岛素敏感性，降低胰岛素抵抗，且肌醇DCI疗效优于肌醇MI。
