Comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in polycystic ovary syndrome: a randomized controlled clinical trial

Summary

Objective

To our knowledge, data on comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in subjects with polycystic ovary syndrome (PCOS) are limited. This study was carried out to compare myo-inositol and metformin on clinical, metabolic and genetic parameters in subjects with PCOS.

Design, Patients and Measurements

This randomized controlled trial was conducted among 60 subjects with PCOS aged 18-40 years. Subjects were randomly allocated into two groups to receive either myo-inositol (N=30) or metformin (N=30) for 12 weeks. Gene expression of inflammatory cytokines was assessed in peripheral blood mononuclear cells (PBMCs) of PCOS women by RT-PCR.

Results

After the 12-week intervention, compared with metformin, myo-inositol intake significantly decreased serum total testosterone (-1.4±4.2 vs. +0.7±1.4 nmol/l, P=0.03), modified Ferriman Gallwey (mF-G) scores (-1.1±0.7 vs. -0.5±0.8, P=0.01) and serum high-sensitivity C-reactive protein (hs-CRP) levels (-2.6±3.9 vs. +0.2±1.5 mg/L, P<0.001). RT-PCR demonstrated that, compared with metformin, myo-inositol downregulated gene expression of interleukin-1 (IL-1) (P=0.02) in PBMCs of subjects with PCOS. We did not observe any significant effect of myo-inositol intake compared with metformin on other hormonal profiles, plasma nitric oxide (NO) or gene expression of IL-8 and tumour necrosis factor alpha (TNF-α).

Conclusions

Overall, taking myo-inositol, compared with metformin, for 12 weeks in PCOS patients with hyperinsulinism and normoinsulinism had beneficial effects on total testosterone, mFG scores, serum hs-CRP levels, and gene expression of IL-1, but did not affect other hormonal profiles, NO levels, or gene expression of IL-8 and TNF-α.

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