Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan.
Department of Gynecology and Obstetrics, Hayatabad Medical Complex, Peshawar, Pakistan.
Endocrine. 2023 Jan;79(1):208-220. doi: 10.1007/s12020-022-03198-2. Epub 2022 Sep 28.
The present study aimed to assess whether treatment with combined resveratrol and myoinositol is more effective in ameliorating the altered parameters associated with PCOS when compared to the combined metformin and pioglitazone therapy.
One hundred and ten obese, oligo-anovulatory PCOS women, aged 20-35 years were randomly assigned into two treatment arms. Participants in arm-1 (n = 55), received combination of metformin and pioglitazone (500 mg and 15 mg, respectively), twice daily, while those in arm-2 (n = 55) received combination of resveratrol and myoinositol (1000 mg and 1000 mg, respectively) twice daily for 12 weeks. Evaluations performed at baseline were repeated after 3 months of therapy. The endocrine and metabolic derangements were assessed by measuring serum levels of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), adiponectin and insulin using ELISA. Cohen's perceived stress scale (PSS) was employed as a subjective measure of stress.
Pre-treatment PCOS women in both the arms (arm-1 and arm-2) had remarkably elevated serum testosterone and insulin concentrations, low serum adiponectin and high perceived stress response scores. The treatment reduced the altered endocrine indices in arm-2 (resveratrol and myoinositol) participants, manifested by statistically significant reduction in serum testosterone level (p = 0.001) and notably increased serum adiponectin level (p = 0.001). Interestingly, the hormonal profile, including serum LH and FSH levels also decreased (p < 0.001) along with a marked reduction in the ovarian volume (p = 0.001) in arm-2 participants. There was a significant reduction in weight (<0.001), BMI (p < 0.001) and an improvement in waist-hip ratio (p < 0.001) in arm-2 participants compared to arm-1 group. The PSS scores of the arm-2 subjects improved significantly (p < 0.001) whereas, the Ferrimen-Gallwey score was improved in both the arms (arm-1 and arm-2; p = 0.010 and 0.008 respectively) however, the change was highly significant in arm-2. Interestingly, the menstrual regularity was 81.4% in arm-2 while 18.2% in arm-1. We conclude that the therapeutic intervention with combined resveratrol and myoinositol is more effective in ameliorating altered endocrine, metabolic indices and stress burden and could be of clinical importance in high risk group of obese, oligo-anovulatory married PCOS affected women.
ClinicalTials.gov Trial No: NCT04867252. Registered 24 April, 2021, https://clinicaltrials.gov/ct2/show/NCT04867252.
本研究旨在评估与二甲双胍和吡格列酮联合治疗相比，白藜芦醇和肌醇联合治疗是否更能改善多囊卵巢综合征相关的改变参数。
110 名年龄在 20-35 岁的肥胖、排卵障碍的多囊卵巢综合征女性被随机分为两组。第 1 组（n=55）接受二甲双胍和吡格列酮联合治疗（分别为 500mg 和 15mg，每日 2 次），第 2 组（n=55）接受白藜芦醇和肌醇联合治疗（分别为 1000mg 和 1000mg，每日 2 次），共治疗 12 周。在基线评估时，在治疗 3 个月后重复评估。通过酶联免疫吸附法测量血清睾酮、黄体生成素（LH）、卵泡刺激素（FSH）、脂联素和胰岛素水平，评估内分泌和代谢紊乱。采用科恩感知压力量表（PSS）作为压力的主观测量。
两组（第 1 组和第 2 组）治疗前的多囊卵巢综合征女性血清睾酮和胰岛素浓度明显升高，血清脂联素水平降低，感知压力反应评分较高。第 2 组（白藜芦醇和肌醇）治疗后，改变了内分泌指标，血清睾酮水平显著降低（p=0.001），血清脂联素水平显著升高（p=0.001）。有趣的是，第 2 组的激素谱，包括血清 LH 和 FSH 水平也降低（p<0.001），同时卵巢体积明显减小（p=0.001）。第 2 组患者的体重（p<0.001）、BMI（p<0.001）显著降低，腰臀比（p<0.001）改善。与第 1 组相比，第 2 组患者的 PSS 评分显著改善（p<0.001），而第 1 组和第 2 组的 Ferrimen-Gallwey 评分均有改善（p=0.010 和 0.008），但第 2 组的改善更为显著。有趣的是，第 2 组的月经规律率为 81.4%，而第 1 组为 18.2%。我们得出结论，白藜芦醇和肌醇联合治疗在改善内分泌、代谢指标和减轻压力负担方面更有效，可能对肥胖、排卵障碍的多囊卵巢综合征高危已婚女性具有重要的临床意义。
ClinicalTrials.gov 试验编号：NCT04867252。注册于 2021 年 4 月 24 日，https://clinicaltrials.gov/ct2/show/NCT04867252。
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