Myoinositol Treatment and Asprosin Levels in PCOS
Condition: PCOS; Insulin Resistance
MeSH terms: Marfan Syndrome; Insulin Resistance
Study type: Interventional

Summary: 
      Policystic ovary syndrome is the most common endocrinopthy during reproductive period. One of
      the factors implicated in the pathogenesis is insulin resistance. Asprosin, which is secreted
      from white adipose tissue is a new candidate for insulin resistance. Myoinositol is known to
      reduce insulin resistance in PCOS patients. The effect of myoinsitol on serum asprosin levels
      is unknown yet. This study aimed to evaluate the effect of myoinositol on serum asprosin
      levels in PCOS patients.
    

Detailed description: 
      In addition to being the most common reproductive endocrinopathy in the population,
      polycystic ovary syndrome (PCOS) also carries a significantly increased risk for metabolic
      syndrome and type 2 diabetes. Insulin resistance and hyperinsulinemia are common findings in
      women with PCOS and are among the most contributing factors to hyperandrogenism in PCOS. This
      situation directly increases both ovarian and adrenal androgen release.

      Because of the pathophysiological link between insulin resistance and PCOS, insulin
      sensitizers have been used in treatment of the disease through this mechanism. Metformin is
      the most common insulin sensitizer used in many countries for type 2 diabetes and
      non-diabetic patients with high insulin resistance with PCOS in the last 50 years. Current
      evidence suggests that metformin may have metabolic and reproductive system benefits, such as
      weight loss, insulin resistance, and reduction of androgen levels, as well as restoration of
      normal menstrual cycle and ovulation. However, major side effects such as nausea, vomiting,
      and gastrointestinal discomfort limit metformin use. The poor compliance observed with
      metformin use has prompted clinicians worldwide to find new approaches for PCOS.

      Myo-inositol (MI) and d-chiro-inositol (DCI) are two of the 9 isomers of vitamin B6. MI and
      DCI, a naturally occurring compound, has been increasingly investigated over the past decade
      for its insulin sensitizing effects. As the postreceptor second messenger of the insulin
      signal, it interacts with GLUT4 via membrane-bound sodium-dependent channels and reduces
      hyperinsulinemia. Also, MI improves ovarian function, decreases lutinizing hormone / follicle
      stimulating hormone (LH / FSH) ratio, serum androgens, total testosterone and free
      testosterone levels.

      Asprosin is a newly discovered peptide hormone associated with insulin resistance and
      increases hepatic glucose production. Produced from abnormally increased white adipose tissue
      in insulin resistant mammals. A recent study found that serum asprosin levels were elevated
      in PCOS patients and this was positively correlated with insulin resistance.

      Based on these data, it has been suggested that the known positive effects of MI + DCI
      (inofolic combi) and metformin treatments on insulin resistance may also be on serum asprosin
      levels. This effect will be demonstrated with this study.

      In this study, it was aimed to investigate and to compare the change on serum asprosin levels
      in patients with polycystic ovary syndrome after the treatment with metformin or myo-inositol
      + d-chiro inositol + folic acid.
    

Intervention name(s): inofolic combi; Glucophage 500Mg Tablet
Intervention type(s): Drug; Drug
Intervention description(s): The patients in this group were given inofolic combi once a day for 12-16 weeks; The patients in this group were given glucophage three times a day for 12-16 weeks
Other intervention name(s): inofolic combi, ITF company; glucophage, Merck company
Intervention MeSH terms: Metformin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Polycystic ovary syndrome; Myoinositol; Metformin; Insulin resistance; Asprosin