Effectiveness of Myoinositol alone or in Companion with Metformin in Improving Hormonal, Metabolic, and Clinical Features of PCOS Women

Abstract

Polycystic ovary syndrome (PCOS) referring to a syndrome that is recognized as a life-course disease and has both metabolic and reproductive signs; main pathophysiological cause includes insulin resistance, hyperandrogenism, and oxidative stress state. The study aimed to assess the impact of Myoinositol alone, metformin alone, or myoinositol in companion with Metformin, on improving clinical, metabolic, and hormonal parameters in females with PCOS. A clinical trial that was prospective, randomized, and comparative on 54 female patients with PCOS (aged 18-40 y) are divided into three groups: group1 patients allocated to receive Myoinositol(4g), group2 patients assigned to receive Metformin(1g) and group3 patients assigned to receive Myoinositol(4g) + Metformin(1g) all for three months. Baseline and post-intervention fasting blood samples were collected to evaluate hormonal {testosterone, luteinizing hormone, follicle stimulating hormone and estradiol}, metabolic parameters {fasting insulin, fasting glucose}, and oxidative stress biomarkers{Glutathione peroxidase}. Metformin and Myoinositol together lead to a significant drop free testosterone (P = 0.002), LH (P= 0.003), LH to FSH ratio(P=0.004), FSI (P= 0.012), the Homeostatic Model Assessment of insulin resistance (HOMA IR) HOMA IR (p= 0.019), hirsutism score (p<0.001) and acne score (p= 0.003), besides substantial increase in GPX (P =0.02). Meanwhile, Myoinositol supplement causes a substantial drop in free testosterone (p=0.013), FSI (P =0.02), and HOMA – IR (P value=0.025) also a substantial rise in Glutathione peroxidase (GPX) (P=0.005). Combining Myoinositol with metformin resulted in improving clinical, metabolic, hormonal parameters, as well as oxidative indicators for PCOS females.