Assessment of Symptoms, Pregnancy Outcome, and Health-Related Quality of Life among PCOS women Treated with Myo inositol and Metformin
Keywords:Polycystic Ovary Syndrome, Myoinositol, Metformin, Health Related Quality of life.
PCOS is a complicated endocrine disorder that mostly affects between 5% and 10% of women who are of reproductive age. Obesity, hyperandrogenism, and oligo- or anovulation are frequent clinical PCOS signs.
Objective: the study was designed to evaluate the effect of combining Metformin and Myoinositol; the main insulin-sensitizing drugs on improving symptoms and HRQOLQ in PCOS women.
Materials and Methods: A study was a prospective, interventional, comparative clinical study conducted on 54 patients (aged 18-40 y) who are divided into three groups: group1 patients allocated to receive Myo-inositol(4g), group2 patients allocated to receive Metformin(1g) and group3 patients allocated to receive Myo-inositol(4g) + Metformin(1g) all for 3 months. Baseline and after 3 months, patients’ information and health related quality of life were documented.
Result: Metformin and Myoinositol resulted in symptoms improvement within each study groups as (68.8%, 87.5% and 94.1%) for group 1,2 and 3 respectively, only 4 patients from all groups became pregnant. Also, significant change in HRQOLQ in all study groups after three months of treatment were reported.
Conclusion: combining Myoinositol with metformin results in improved PCOS symptoms and pregnancy outcome in addition to improved patient’s quality of life.
- Sadeghi HM, Adeli I, Calina D, Docea AO, Mousavi T, Daniali M, et al.Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. International journal of molecular sciences 6 Jan. 2022, vol. 23,2 583.doi:10.3390/ijms23020583.
- Rudnicka E, Kunicki M, Suchta K, Machura P, Grymowicz M, Smolarczyk R. “Inflammatory Markers in Women with Polycystic Ovary Syndrome.” BioMed research international 4 Mar. 2020, vol. 2020 4092470. doi:10.1155/2020/4092470
- Coutinho, Kauffman. The Role of the Brain in the Pathogenesis and Physiology of Polycystic Ovary Syndrome (PCOS). Med Sci. 2019;7(8):84.
- Rashid R, Mir SA, Kareem O, Ali T, Ara R, Malik A, et al. polycystic ovarian syndrome-current pharmac-othe-rapy and clinical implications. Taiwan J Obstet Gynecol [Internet]. 2022;61(1):40–50. Available from: https://doi.org/10.1016/j.tjog.2021.11.009
- Waheed, HJ, Saifallah PH, Salman IN. Study of Some Cytokines and Hormones in a Sample of Iraqi women with polycystic ovarian syndrome and Their Relation to Obesity. Al Mustansiriyah J Pharm Sci. 2013;13(2):58–64.
- Ahmed R. MAL. Role Of Insulin Like Growth Factor in Polycystic Ovary Syndrome. Egypt J Hosp Med. 2018;72(2):4005–11.
- Chhetri DR. Myo-inositol and its derivatives: Their emerging role in the treatment of human diseases. Front Pharmacol. 2019;10(October):1–8.
- Shaheed HS, Jasim SY, Abbass WAK. Studying some novel biochemical and immunological markers in a sample of Iraqi women with polycystic ovarian syndrome. Res J Pharm Technol. 2020;13(7) :3171–8.
- 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;6(8): 647–58.
- Lashen H. Review: Role of metformin in the management of polycystic ovary syndrome. Vol. 1, Therapeutic Advances in Endocrinology and Metabolism. 2010. P: 117–28.
- Cwynar-Zając Ł. Metformina – nowe podejście. Pediatr Endocrinol Diabetes Metab. 2021;27(2):134–40.
- Mahdi MF, Arif IS, Jubair NK. Design, Synthesis and Preliminary Pharmacolo-gical Evaluation of New Metformin Derivatives. Int J Pharm Pharm Sci. 2016;9(1):239.
- Liang X, Giacomini KM. Transporters Involved in Metformin Pharmacokin-etics and Treatment Response. J Pharm Sci [Internet]. 2017;106(9): 2245–50. Available from: http://dx.doi.org/10.1016/j.xphs.2017.04.078
- Ilias I, Rizzo M, Zabuliene L. Metformin: Sex/Gender Differences in Its Uses and Effects—Narrative Review. Med. 2022;58(3):1–14.
- DiNicolantonio JJ, H O’Keefe J. Myo-inositol for insulin resistance, metabolic syndrome, polycystic ovary syndrome and gestational diabetes. Open Hear. 2022;9(1): e001989.
- Regidor PA, Schindler AE. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. Int J Endocrinol. 2016;2016.
- Thomas MP, Mills SJ, Potter BVL. The “Other” Inositols and Their Phosphates: Synthesis, Biology, and Medicine (with Recent Advances in myo-Inositol Chemistry). Angew Chemie - Int Ed. 2016;55(5):1614–50.
- Gambioli R, Forte G, Buzzaccarini G, Unfer V, Laganà AS. Myo-inositol as a key supporter of fertility and physiological gestation. Pharmaceut-icals. 2021;14(6):1–19.
- Gupta D, Khan S, Islam M, Malik BH, Rutkofsky I. Myo-Inositol’s Role in Assisted Reproductive Technology: Evidence for Improving the Quality of Oocytes and Embryos in Patients with Polycystic Ovary Syndrome. Cureus. 2020;12(5).
- Sobota-Grzeszyk A, Kuźmicki M, Szamatowicz J. Myoinositol in the Prevention of Gestational Diabetes Mellitus: Is It Sensible? J Diabetes Res. 2019;2019.
- Dinicola S, Unfer V, Facchinetti F, Soulage CO, Greene ND, Bizzarri M, et al. Inositols: From established knowledge to novel approaches. Int J Mol Sci. 2021;22(19):1–30.
- Saadia Z. Follicle Stimulating Hormone (LH: FSH) Ratio in Polycystic Ovary Syndrome (PCOS) - Obese vs. Non- Obese Women. Med Arch (Sarajevo, Bosnia Herzegovina). 2020;74(4):289–93.
- Cook D, Dunaif A, Epidemiology C, Biostatistics LC. Development of a Health-Related Quality-of-Life Ques-tionnaire (PCOSQ) for Women with Polycystic Ovary Syndrome (PCOS)*. 1998;83(6):1976–87.
- Böttcher B, Fessler S, Friedl F, Toth B, Walter MH, Wildt L, et al. Health-related quality of life in patients with polycystic ovary syndrome: validation of the German PCOSQ-G. Arch Gynecol Obstet [Internet]. 2018;297 (4):1027–35. Available from: https://doi.org/10.1007/s00404-017-4623-2
- Abbott DH, Dumesic DA, Levine JE, Angeles L. Implications for Pathophy-siology and Therapy. 2020;14(2):131–43.
- Anupama, Arora H, RaviBahad AK, Naithani M, Bahurupi Y, Chaturvedi J, et al. Comparison of Clinical, Metabolic and Hormonal Effects of Metformin Versus Combined Therapy of Metformin with Myoinositol Plus D-Chiro-Inositol in Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. Cureus. 2021;13(6):3–9.
- Tehrani HG, Mostajeran F, Shahsavari S. The effect of calcium and vitamin D supplementation on menstrual cycle, body mass index and hyperandrogenism state of women with poly cystic ovarian syndrome. J Res Med Sci.vol. 19.9 (2014): 875-80
- Begum GS, Shariff A, Ayman G, Mohammad B, Housam R, Khaled N. Assessment of Risk Factors for development of polycystic ovarian syndrome. Int J Contemp Med Res [Internet]. 2017;4(1):2454–7379. Available from: www.ijcmr.com
- Vink JM, Sadrzadeh S, Lambalk CB, Boomsma DI. Heritability of polycystic ovary syndrome in a Dutch twin-family study. J Clin Endocrinol Metab. 2006;91(6):2100–4.
- Yahya AA, Abdulridha MK, Al-Rubuyae BJ. The Effect of Vitamin D3 and Co-enzyme Q10 Supplemen-tation on Metabolic Biomarkers in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome. Al Mustansiriyah J Pharm Sci. 2018;18(2):142–50.
- Fabiana Meijon Fadul. 済無No Title No Title No Title. 2019;
- HEayek S, Bitar L, Hamdar LH, Mirza FG, Daoud G. Poly Cystic Ovarian Syndrome: An updated overview. Front Physiol. 2016;7(APR):1–15.
- Pradhan J, Mishra I, Rattan R, Choudhury AK, Baliarsinha AK. Correlation of markers of inflammation with hormonal, metabolic parameters, insulin resistance and adiposity indices in first-degree relatives of patient with polycystic ovary syndrome. J Hum Reprod Sci. 2022;15(3):250–8.
- Gnawali A, Patel V, Cuello-Ramírez A, Al kaabi AS, Noor A, Rashid MY, et al. Why are Women with Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological Maze. Cureus. 2021;13(2).
- Allahbadia GN, Merchant R. Polycystic ovary syndrome and impact on health. Middle East Fertil Soc J. 2011;16(1):19–37.
- Qamar H, Mustafa R. Role of Myo-Inositol in Treatment of Young Females Affected by Polycystic Ovarian Syndrome: Quasi Experimental Study. J Bahria Univ Med Dent Coll. 2021;10(02):142–6.
- Nas K, Tűű L. A comparative study between myo-inositol and metformin in the treatment of insulin-resistant women. Eur Rev Med Pharmacol Sci. 2017;21(2):77–82.
- Nabi S, Guleria R. Comparison of Myoinositol and Metformin in Women with Polycystic Ovarian Syndrome. Clini Cal Study. 2020;30 (11):1045–9.
- Chirania K, Misra S, Behera S. A randomised clinical trial comparing myoinositol and metformin in PCOS. Int J Reprod Contraception, Obstet Gynecol. 2017;6(5):1814.
- Taghavi SA, Bazarganipour F, Montazeri A, Kazemnejad A, Chaman R, Khosravi A. Health-related quality of life in polycystic ovary syndrome patients: A systematic review. Iran J Reprod Med. 2015;13(8):473–82.
- Behboodi Moghadam Z, Fereidooni B, Saffari M, Montazeri A. Measures of health-related quality of life in pcos women: A systematic review. Int J Womens Health. 2018; 10:397–408.
- Alghadeer S, Algarawi A, Abu-Rkybah F, Alshebly MM, and Alruthia Y. The translation and validation of the Arabic Version of the Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (AR-PCOSQ). BMC women's health 29 Oct. 2020, vol. 20,1 244. doi:10.1186/s12905-020-01108-0.
- Fatemeh B, Shahideh JS, Negin M. Health related quality of life and psychological parameters in different polycystic ovary syndrome phenotypes: a comparative cross-sectional study. J Ovarian Res. 2021;14(1):1–9.
- Miazgowski T, Martopullo I, Widecka J, Miazgowski B, Brodowska A. National and regional trends in the prevalence of polycystic ovary syndrome since 1990 within Europe: The modeled estimates from the Global Burden of Disease Study 2016. Arch Med Sci. 2021;17(2):343–51.
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