Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials

Table 3

Biochemical and clinical findings related to hyperandrogenism and metabolism.

Ref	Treatment	Testosterone (ng/dL)	Androstenedione (ng/mL)	Free testosterone (ng/dL)	Insulin (µU/mL)	HOMA index	OGTT	SHBG (nmol/L)	General findings
[20]	Myo-Ins; versus; FA	54.8 ± 6.2; versus; 55.2 ± 9.1	1.70 ± 0.29; versus; 1.91 ± 0.24	NA	6.5 ± 1.1; versus; 11.3 ± 1.1	1.4 ± 0.3; versus; 2.5 ± 0.7	Myo-Ins improved glucose tolerance	NA	Myo-Ins significantly reduced LH, PRL, insulin levels, and LH/FSH ratio and significantly improved insulin sensitivity and menstrual cyclicity was restored in amenorrheic and oligomenorrheic subjects.
[21]	Myo-Ins; versus; FA	34.8 ± 4.3; versus; 109.0 ± 7.5	1.96 ± 0.26; versus; 3.06 ± 0.41	0.24 ± 0.03; versus; 0.85 ± 0.13	26.0 ± 8.0; versus; 38.0 ± 7.0	NA	Myo-Ins improved glucose tolerance	198.0 ± 24.0; versus; 163.0 ± 26.0	Myo-Ins increased insulin sensitivity and improved glucose tolerance and insulin release. There was a significant reduction in total and free T. There was a decrement in systolic and diastolic blood pressure. Plasma triglycerides and total cholesterol concentration decreased.
[10]	Myo-Ins; versus; placebo	101.0 (81–121); versus; 121.0 (101–141)	Decreased in Myo-Ins group	NA	No significant difference	NA	No significant difference	36.5; versus; 26.3	Myo-Ins showed a beneficial effect in improving ovarian function in PCOS women with oligomenorrhea.
[11]	Myo-Ins; versus; FA	95.0 (72–115); versus; 118.0 (98–138)	Decreased in Myo-Ins group	NA	16.8; versus; 17.3	NA	No significant difference	35.9; versus; 25.8	Myo-Ins treatment showed a beneficial effect in improving ovarian function, anthropometric measures,; and lipid profile.
[22]	Myo-Ins + D-chiro-Ins; versus; Myo-Ins	32.7 ± 10.0; versus; 40.1 ± 9.5	1.94 ± 0.15; versus; 1.98 ± 0.19	0.23 ± 0.02; versus; 0.24 ± 0.03	9.2 ± 2.1; versus; 9.6 ± 1.9	1.5 ± 0.28; versus; 1.9 ± 2.1	Myo-Ins + D-chiro-Ins improved glucose tolerance	208 ± 20; versus; 202 ± 27	Both treatments, Myo-Ins + D-chiro-Ins, or Myo-Ins alone normalized the metabolic parameters and restored ovulation in overweight PCOS women. At the end of the treatment both the fasting insulin and glucose serum concentration level were significantly reduced. However, compared to Myo-Ins alone, the combined treatment has shown significant changes on the metabolic profile after only 12 weeks.
[23]	Myo-Ins + D-chiro-Ins; versus; Myo-Ins	NA	4.01 ± 1.7; versus; 3.12 ± 2.23	0.62 ± 0.15; versus; 0.83 ± 0.2	10.7 ± 5.5; versus; 17.8 ± 8.2	1.97 ± 1.48; versus; 2.8 ± 1.4	NA	35.85 ± 24.3; versus; 21.36 ± 7.57	Myo-Ins + D-chiro-Ins decreased significantly LH, free T levels, HOMA index, and fasting insulin. The combined treatment significantly increased E2 and SHBG. No relevant side effects were recorded. Therefore, the combined treatment, Myo-Ins + D-chiro-Ins, is effective in improving endocrine and metabolic parameters in young obese PCOS women.

Myo-Ins, myo-inositol; D-chiro-Ins, D-chiro-inositol; FA, folic acid; PCOS, polycystic ovary syndrome; PRL, prolactin; E2, oestradiol; A, androstenedione; 17OHP, 17-hydroxyprogesterone; T, testosterone; P, progesterone; OGTT, oral glucose tolerance; BMI, body mass index; LH, luteinizing hormone; FSH, follicle stimulating hormone; DHEAS, dehydroepiandrosterone; SHBG, sex hormone binding globulin; AUC, area under the curve of OGTT; VLDL, very-low-density lipoprotein; LDL, low-density lipoprotein; HDL, high-density lipoprotein; WHR, waist-to-hip ratio.
OGTT performed sampling 15 minutes before and 30, 60, 90, 120, and 240 minutes after the oral assumption of 75 g of glucose.
Values are mean ± SD. Values are mean ± SEM. Values are mean (CIs), confidence intervals (95%). A brief description is inserted in the table when numerical data are not available in the original article. The units were made uniform to show more comparable results.
value: ≤0.05; ≤0.01; ≤0.001: comparison posttreatment experimental group versus control.
value: ≤0.05; ≤0.01; ≤0.001: comparison posttreatment with respect to baseline. Data at baseline are not shown in the table.