ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
Dergisi

Turkish Journal of Reproductive Medicine and Surgery

Dernek Sitesi
Kayıtlı İndexler
DERLEMELER

Polikistik Over Sendromu Tedavisinde Myo-İnositol’ün Rolü
The Role of Myo-Inositol in the Treatment of Polycystic Over Syndrome
Received Date : 09 Jul 2019
Accepted Date : 20 Oct 2019
Available Online : 08 Jun 2020
Doi: 10.24074/tjrms.2019-70666 - Makale Dili: TR
TJRMS. 2019;3(1):22-8
ÖZET
Polikistik over sendromu, üreme çağında en sık görülen endokrinolojik hastalıktır ve anovulasyonun en sık nedenidir. İnsülin direncinin PKOS etyopatogenezinde rol oynayabileceği ve insülin duyarlılaştırıcıların PKOS hastalarında başarı ile kullanımları, yeni araştırmalara yol gösterici olmaktadır. B6 vitamininin steroizomeri olan myoinositol üzerine son zamanlarda çok sayıda çalışma yapılmaktadır ve bu çalışmaların sonuçlarında genel izlenim myoinositol kullanımının olumlu olduğu yönündedir.
ABSTRACT
Polycystic ovary syndrome is the most common endocrinological disease in the reproductive age and most common cause of anovulation. Insulin resistance may play a role in the etiopathogenesis of PCOS and the successful use of insulin sensitizers in PCOS patients is giving new insights for the treatment for new studies. There have been many studies on myoinositol, the steroisomer of vitamin B6, and the general impression of these studies is that myoinositol use is positive.
SITE.TEXT.RESOURCES
  1. Tsilchorozidou T Overton C, and Conway GS. The pathophysiology of polycystic ovary syndrome. Clin Endocrinol (Oxf).2004;60(1):1-17. [Crossref]  [PubMed] 
  2. Stein I, Leventhal M. Amenorrhea associated with bilaterl polycystic ovaries. Am J Obstet Gynecol 1935;29:181-5. [Crossref] 
  3. Azziz R. Defition, diagnosis and epidemiology of polycystic ovary syndrome, Chap.1. Azziz R, editor. The polycystic ovary syndrome: currenct concepts in pathogenesis and clinical care. 1st ed. Berlin: Springer; 2007. p. 1-16. [Crossref] 
  4. Rotterdam ESHRE/ARSM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycysic ovary syndrome. Fertil Steril 2004;81:19-25. [Crossref]  [PubMed] 
  5. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF; Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45. [Crossref]  [PubMed] 
  6. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF; Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91(2):456-88. doi: 10.1016/j.fertnstert. 2008.06.035. [Crossref]  [PubMed] 
  7. Ciampelli M, Fulghesu AM, Cucinelli F, Pavone V, Ronsisvalle E, Guido M, Caruso A, Lanzone A. Impact of insuline and body mass index on metabolic and endocrine variables in polycystic ovary syndrome. Metabolism. 1999;48(2):167-72. [Crossref] 
  8. Genazzani AD, Battaglia C, Malavasi B, Strucchi C, Tortolani F, Gamba O. Metformin administration modulates and restores luteinizing hormone spontaneous episodic secretion and ovarian function in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2004;81(1):114-9). [Crossref]  [PubMed] 
  9. Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin Reprod Endocrinol. 1997;15(2):111-22. [Crossref]  [PubMed] 
  10. Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update.2010; 16:347-63. [Crossref]  [PubMed] 
  11. Kim J, Mersereau JE, Khankari N, Bradshaw PT, McCullough LE, Cleveland R, et al. 2016. Polycystic ovarian syndrome (PCOS), related symptoms/ sequelae, and breast cancer risk in a population-based case-control study. Cancer Causes & Control. 2016; 27:403-14. [Crossref]  [PubMed]  [PMC] 
  12. Eagle H, Oyama VI, Levy M, Freeman A. Myo -Inositol as an essential growth factor for normal and malignant human cells in tissue culture. Science. 1956 May 11;123(3202):845-7. [Crossref]  [PubMed] 
  13. Chau JF, Lee MK, Law JW, Chung SK, Chung SS. Sodium/myo-inositol cotransporter-1 is essential for the development and function of the peripheral nerves. FASEB J. 2005;19(13): 1887-9. [Crossref]  [PubMed] 
  14. Dai Z, Chung SK, Miao D, Lau KS, Chan AW, Kung AW. Sodium/myo-inositol cotransporter 1 and myo-inositol are essential for osteogenesis and bone formation, J. Bone Miner. Res. 2011;26(3):582-90. doi: 10.1002/jbmr.240. [Crossref]  [PubMed] 
  15. Beemster P, Groenen P, Steegers-Theunissen R. Involvement of inositol in reproduction. Nutr. Rev. 2002;60(3):80-7. [Crossref]  [PubMed] 
  16. Condorelli A, La Vignera S, Di Bari F, Unfer V, Calogero AE. Effects of myo inositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci. 2011;15(2):129-34.
  17. Ciotta L, Stracquadanio M, Pagano I, Carbonaro A, Palumbo M, Gulino F. Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci. 2011;15(5):509-14.
  18. Masaeli A, Nayeri H, Mirzaee M.Effect of Metformin Treatment on Insulin Resistance Markers, and Circulating Irisin in Women with Polycystic Ovarian Syndrome (PCOS). Horm Metab Res. 2019 May 23. doi: 10.1055/a-0896-1130. [Crossref]  [PubMed] 
  19. Trolle B, Flyvbjerg A, Kesmodel U, et al. Efficacy of metformin in obese and non-obese women with polycystic ovary syndrome: a randomized, double-blinded, placebo-controlled cross-over trial. Hum Reprod. 2007;22:2967-2973. [Crossref]  [PubMed] 
  20. Erensoy H, Niafar M, Ghafarzadeh S, Aghamohammadzadeh N, Nader ND.A pilot trial of metformin for insulin resistance and mood disturbances in adolescent and adult women with polycystic ovary syndrome. Gynecol Endocrinol. 2019 Jan;35(1):72-75. doi: 10.1080/09513590.2018.1498476. [Crossref]  [PubMed] 
  21. Kupreeva M, Diane A, Lehner R, Watts R, Ghosh M, Proctor S, Vine D.Effect of metformin and flutamide on insulin, lipogenic and androgen-estrogen signaling, and cardiometabolic risk in a PCOS-prone metabolic syndrome rodent model. Am J Physiol Endocrinol Metab. 2019 Jan 1;316(1):E16-E33. doi: 10.1152/ajpendo.00018.2018. [Crossref]  [PubMed]  [PMC] 
  22. Tao T, Wu P, Wang Y, Liu W.Comparison of glycemic control and β-cell function in new onset T2DM patients with PCOS of metformin and saxagliptin monotherapy or combination treatment. BMC Endocr Disord. 2018 Feb 27;18(1):14. doi: 10.1186/s12902-018-0243-5. [Crossref]  [PubMed]  [PMC] 
  23. Larner J. D-chiro-inositol-its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res 2002;3:47-60. [Crossref]  [PubMed]  [PMC] 
  24. Croze ML, Soulage CO. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie 2013;95:1811-27. [Crossref]  [PubMed] 
  25. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003;7:151-9.
  26. Genazzani AD, Prati A, Santagni S, et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012;28:969-73. [Crossref]  [PubMed] 
  27. Unfer V, Porcaro G. Updates on the myo-inositol plus d-chiroinositol combined therapy in polycystic ovary syndrome. Expert Rew Clin Pharmacol. 2014;7:623-31. [Crossref]  [PubMed] 
  28. Genazzani AD, Lanzoni C, Ricchieri F, Jasonni VM. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecol Endocrinol 2008;24:139-44. [Crossref]  [PubMed] 
  29. Artini PG, Di Berardino OM, Papini F, et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013;29:375-9. [Crossref]  [PubMed] 
  30. Venturella R, Mocciaro R, De Trana E, et al. Assessment of the modification of the clinical, endocrinal and metabolical profile of
  31. patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol 2012;64:239-43.
  32. Papaleo E, Unfer V, Baillargeon J-P, et al. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecol Endocrinol 2007;23:700-3. [Crossref]  [PubMed] 
  33. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myoinositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012;28:509-15. [Crossref]  [PubMed] 
  34. Shokrpour M, Foroozanfard F, Ebrahimi FA, Vahedpoor Z, Aghadavod E, Ghaderi A, Asemi Z. Comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome: a randomized controlled clinical trial. Gynecol Endocrinol. 2019;35(5):406-411. [Crossref]  [PubMed] 
  35. Facchinetti F, Orrù B, Grandi G, Unfer V. Short-term effects of metformin and myo-inositol in women with polycystic ovarian syndrome (PCOS): a meta-analysis of randomized clinical trials. Gynecol Endocrinol. 2019 Mar;35(3):198-206. doi:10.1080/095 13590.2018.1540578. [Crossref]  [PubMed] 
  36. Coskun A, Ercan O, Arikan DC, Özer A, Kilinc M, Kiran G, Kostu B. Modified ferriman-gallwey hirsutism score and androgen levels in turkish women. Eur J Obstet Gynecol Reprod Biol 2011; 154: 167-171. [Crossref]  [PubMed] 
  37. Ozay AC, Emekci Ozay O, Okyay RE, Cagliyan E, Kume T, Gulekli B. Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women. Int J Endocrinol. 2016;2016:3206872. [Crossref]  [PubMed]  [PMC] 
  38. Zacchè MM, Caputo L, Filippis S, Zacchè G, Dindelli M, Ferrari A. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009 Aug;25(8):508-13. doi: 10.1080/09513590903015544. [Crossref]  [PubMed] 
  39. Morgante G, Cappelli V, Di Sabatino A, Massaro MG, De Leo V. Polycystic ovary syndrome (PCOS) and hyperandrogenism: the role of a new natural association. Minerva Ginecol. 2015 Oct;67(5):457-63.
  40. Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC Complement Altern Med. 2017 Nov 25;17(1):500. doi: 10.1186/s12906-017-2011-x. [Crossref]  [PubMed]  [PMC] 
  41. Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr Connect. 2017 Nov;6(8):647-658. doi: 10.1530/EC-17-0243. [Crossref]  [PubMed]  [PMC] 
  42. Piltonen T, Morin-Papunen L, Koivunen R, Perheentupa A, Ruokonen A, Tapanainen JS. Serum antiMüllerian hormone levels remain high until late reproductive age and decrease during metformin therapy in women with polycystic ovary syndrome. Hum Reprod. 2005 Jul;20(7):1820-6. [Crossref]  [PubMed] 
  43. Jonard S, Dewailly D.The follicular excess in polycystic ovaries, due to intra-ovarian hyperandrogenism, may be the main culprit for the follicular arrest. Hum Reprod Update. 2004 Mar-Apr;10(2):107-17. [Crossref]  [PubMed] 
  44. La Marca A, Grisendi V, Dondi G, Sighinolfi G, Cianci A. The menstrual cycle regularization following D-chiro-inositol treatment in PCOS women: a retrospective study. Gynecol Endocrinol. 2015 Jan;31(1):52-6. doi: 10.3109/09513590.2014.964201. [Crossref]  [PubMed] 
  45. Chhabra N, Malik S. Effect of Insulin Sensitizers on Raised Serum Anti-mullerian Hormone Levels in Infertile Women with Polycystic Ovarian Syndrome. J Hum Reprod Sci. 2018;11(4):348-352. doi: 10.4103/jhrs.JHRS_59_17. [Crossref]  [PubMed]  [PMC] 
  46. De Cicco S, Immediata V, Romualdi D, Policola C, Tropea A, Di Florio C, Tagliaferri V, Scarinci E, Della Casa S, Lanzone A, Apa R. Myoinositol combined with alpha-lipoic acid may improve the clinical and endocrine features of polycystic ovary syndrome through an insulin-independent action. Gynecol Endocrinol. 2017 Sep;33(9):698-701. doi: 10.1080/09513590.2017.1313972. [Crossref]  [PubMed] 
  47. Pkhaladze L, Barbakadze L, Kvashilava N. Myo-Inositol in the Treatment of Teenagers Affected by PCOS. Int J Endocrinol. 2016;2016: 1473612. doi: 10.1155/2016/1473612. [Crossref]  [PubMed]  [PMC] 
  48. Asanidze E, Kristesashvili J, Pkhaladze L, Khomasuridze A. The value of anti-Mullerian hormone in the management of polycystic ovary syndrome in adolescents. Gynecol Endocrinol. 2019 May 22:1-4. doi: 10.1080/09513590.2019.1616689. [Crossref]  [PubMed] 
  49. Frary JM, Bjerre KP, Glintborg D, Ravn P. The effect of dietary carbohydrates in women with polycystic ovary syndrome: a systematic review. Minerva Endocrinol. 2016 Mar;41(1):57-69.
  50. Facchinetti F, Bizzarri M, Benvenga S, et al. Results from the International Consensus Conference on Myo-inositol and d-chiroinositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS. Eur J Obstet Gynecol Reprod Biol 2015;195:72-6. [Crossref]  [PubMed] 
  51. Morley LC, Tang T, Yasmin E, Norman RJ, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2017 Nov 29;11:CD003053. doi: 10.1002/14651858.CD003053.pub6. [Crossref]  [PMC] 
  52. Kamenov Z, Kolarov G, Gateva A, et al. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol 2015;31:131-5. [Crossref]  [PubMed] 
  53. Rolland AL, Peigné M, Plouvier P, Dumont A, Catteau-Jonard S, Dewailly D.Could myo-inositol soft gel capsules outperform clomiphene in inducing ovulation? Results of a pilot study. Eur Rev Med Pharmacol Sci. 2017 Jun;21(2 Suppl):10-14.
  54. Emekçi Özay Ö, Özay AC, Çağlıyan E, Okyay RE, Gülekli B. Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: a prospective, controlled, randomized trial. Gynecol Endocrinol. 2017 Jul;33(7):524-528. doi: 10.1080/09513590.2017.1296127. [Crossref]  [PubMed] 
  55. Chiu TT, Rogers MS, Briton-Jones C, et al. Effects of myo-inositol on the in-vitro maturation and subsequent development of mouse oocytes. Hum Reprod 2003;18:408-16. [Crossref]  [PubMed] 
  56. Chiu TT, Rogers MS, Law EL, et al. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality. Hum Reprod 2002;17:1591-6. [Crossref]  [PubMed] 
  57. Bevilacqua A, Carlomagno G, Gerli S, et al. Results from the International Consensus Conference on myo-inositol and D-chiro-inositol in Obstetrics and Gynecology-assisted reproduction technology. Gynecol Endocrinol 2015;31:441-6. [Crossref]  [PubMed] 
  58. Papaleo E, Unfer V, Baillargeon JP, et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Fertil Steril 2009;91:1750-4. [Crossref]  [PubMed] 
  59. Lisi F, Carfagna P, Oliva MM, et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod Biol Endocrinol 2012; 2310:52. [Crossref]  [PubMed]  [PMC] 
  60. Showell MG, Mackenzie-Proctor R, Jordan V, Hodgson R, Farquhar C. Inositol for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2018 Dec 20;12:CD012378. doi: 10.1002/14651858. CD012378.pub2. [Crossref] 
  61. Bhide P, Pundir J, Gudi A, Shah A, Homburg R, Acharya G. The effect of myo-inositol/di-chiro-inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019 Apr 16. doi: 10.1111/aogs.13625. [Crossref]  [PubMed] 
  62. Parsanezhad ME, Bagheri MH, Alborzi S, et al. Ovarian stromal blood flow changes after laparoscopic ovarian cauterization in women with polycystic ovary syndrome. Hum Reprod. 2003;18:1432. [Crossref]  [PubMed] 
  63. Okyay E, Gode F, Acet F, et al. The effect of drospirenone (3mg) with ethinyl estradiol (30mcg) containing pills on ovarian blood flows in women with polycystic ovary syndrome: a case controlled study. Eur J Obstet Gynecol Reprod Biol. 2014;180:93-99. [Crossref]  [PubMed] 
  64. Ng E, Chan CC, Yeung WS, et al. Comparison of ovarian stromal blood flow between fertile women with normal ovaries and infertile women with polycystic ovary syndrome. Hum Reprod. 2005;20:1881-1886. [Crossref]  [PubMed] 
  65. Younis JS, Jadaon JE, Haddad S, et al. Prospective evaluation of basal stromal Doppler studies in women with good ovarian reserve and infertility undergoing in vitro fertilization-embryo transfer treatment: patients with polycystic ovary syndrome versus ovulatory patients. Fertil Steril. 2011;95:1754-1758. [Crossref]  [PubMed] 
  66. Adali E, Kolusari A, Adali F, et al. Doppler analysis of uterine perfusion and ovarian stromal blood flow in polycystic ovary syndrome. Int J Gynaecol Obstet. 2009;105:154-157. [Crossref]  [PubMed] 
  67. Özay AC, Emekçi Özay Ö, Okyay RE, Gülekli B. The effect of myoinositol on ovarian blood flows in women with polycystic ovary syndrome. Gynecol Endocrinol. 2019 Mar;35(3): 237-241. doi: 10.1080/09513590.2018.152 0827. [Crossref]  [PubMed] 
  68. Sahu A, Tripathy P, Mohanty J, Nagy A. Doppler analysis of ovarian stromal blood flow changes after treatment with metformin versus ethinyl estradiol-cyproterone acetate in women with polycystic ovarian syndrome: A randomized controlled trial. J Gynecol Obstet Hum Reprod. 2019 May;48(5):335-339. doi: 10.1016/j.jogoh.2018.10.006. [Crossref]  [PubMed] 
  69. Makled AK, El Sherbiny M, Elkabarity R. Assessment of ovarian stromal blood flow after metformin treatment in women with polycystic ovary syndrome. Arch Gynecol Obstet. 2014 Apr;289(4):883-91. doi: 10.1007/s00404-013-3057-8. [Crossref]  [PubMed] 
  70. Ozcimen EE, Uckuyu A, Ciftci FC, Zeyneloglu HB. The effect of metformin treatment on ovarian stromal blood flow in women with polycystic ovary syndrome. Arch Gynecol Obstet. 2009 Aug;280(2):263-9. doi: 10.1007/s00404-008-0904-0. [Crossref]  [PubMed]