Shukla Aparna, Singh Renu, Gupta Anuraag, Goel Apurva, Tiwari Kiran, Singh Satyendra K
Centre for Advanced Research, King George's Medical University, Lucknow, IND.
Obstetrics and Gynaecology Department, King George's Medical University, Lucknow, IND.
Cureus. 2024 Nov 27;16(11):e74571. doi: 10.7759/cureus.74571. eCollection 2024 Nov.
Introduction Insulin resistance is a fundamental factor in the pathogenesis of polycystic ovarian syndrome (PCOS) and has been found to mediate a close association with obesity and dyslipidemia. While the anti-diabetic and anti-inflammatory properties of fenugreek seed extracts have been demonstrated, research on its anti-hyperlipidemic properties is still in its novice stage, with inconclusive evidence. The present study assessed the impact of fenugreek seed extracts rich in furostanolic saponins (Furocyst) on lipid profiles across different categories of body mass index (BMI) in women with PCOS. Methodology The study was a single-blinded, randomized clinical study conducted among 230 patients between 18 and 45 years of age, presenting to the Gynecology and Obstetrics OPD for treatment of PCOS. After screening for eligibility, patients were enrolled and randomized into the experimental group (receiving Furocyst BD for three months) and the placebo group. Blood samples collected before treatment and after the completion of treatment were investigated for insulin resistance and lipid profile. The final analysis was conducted on 188 patients (104 in the Furocyst group and 84 in the placebo group) and stratified for different categories of BMI (based on WHO classification). Results A significant reduction in the mean BMI in all patients overall and in patient subgroups according to BMI was noted after 12 weeks of treatment with Furocyst, which was statistically significant in the obese (p<0.001). The HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) index was also reduced in the Furocyst group across all BMI categories, including sub-classes of obese (p<0.001). The lipid-lowering effects of Furocyst were observed on total cholesterol, triglyceride, and VLDL (very-low-density lipoprotein) in all patients, irrespective of the initial BMI category (p<0.05). The drug did not affect the mean serum HDL (high-density lipoprotein) levels. In obese patients, Furocyst also exhibited a statistically significant reduction in LDL-HDL ratio and cholesterol-HDL ratio. Conclusion The present study demonstrates the insulin-sensitizing, glucose-regulating, anti-obesity, and anti-hyperlipidemic properties of Furocyst in women with PCOS. The overweight and obese seem to benefit most from the drug. The use of Furocyst may be considered a pragmatic approach to treating PCOS-related symptoms and improving metabolic disturbances, specifically by optimizing the lipid profile in the affected women and lowering cardiovascular risk factors in the long term.
引言
胰岛素抵抗是多囊卵巢综合征(PCOS)发病机制中的一个基本因素,并且已发现其介导了与肥胖和血脂异常的密切关联。虽然胡芦巴籽提取物的抗糖尿病和抗炎特性已得到证实,但其抗高血脂特性的研究仍处于初期阶段,证据尚无定论。本研究评估了富含呋甾烷醇皂苷的胡芦巴籽提取物(Furocyst)对PCOS女性不同体重指数(BMI)类别的血脂谱的影响。
方法
该研究是一项单盲、随机临床研究,在230名年龄在18至45岁之间、因PCOS前来妇产科门诊治疗的患者中进行。在筛选合格后,患者被纳入并随机分为实验组(接受Furocyst BD治疗三个月)和安慰剂组。在治疗前和治疗结束后采集血样,检测胰岛素抵抗和血脂谱。最终分析在188名患者(Furocyst组104名,安慰剂组84名)中进行,并根据不同的BMI类别(基于世界卫生组织分类)进行分层。
结果
用Furocyst治疗12周后,所有患者总体以及根据BMI划分的患者亚组的平均BMI均显著降低,在肥胖患者中具有统计学意义(p<0.001)。Furocyst组在所有BMI类别(包括肥胖亚类)中的HOMA-IR(胰岛素抵抗稳态模型评估)指数也有所降低(p<0.001)。无论初始BMI类别如何,在所有患者中均观察到Furocyst对总胆固醇、甘油三酯和极低密度脂蛋白(VLDL)有降脂作用(p<0.05)。该药物对平均血清高密度脂蛋白(HDL)水平无影响。在肥胖患者中,Furocyst还使低密度脂蛋白-高密度脂蛋白比值和胆固醇-高密度脂蛋白比值有统计学意义的降低。
结论
本研究证明了Furocyst对PCOS女性具有胰岛素增敏、血糖调节、抗肥胖和抗高血脂特性。超重和肥胖患者似乎从该药物中获益最大。使用Furocyst可被视为一种治疗PCOS相关症状和改善代谢紊乱的实用方法,特别是通过优化受影响女性的血脂谱并长期降低心血管危险因素。