title: Inositol's and other nutraceuticals' synergistic actions counteract insulin resistance in polycystic ovarian syndrome and metabolic syndrome: state-of-the-art and future perspectives.
abstract: The incidence of metabolic syndrome (MetS), type II diabetes (T2D) and polycystic ovarian syndrome (PCOS) has been progressively increasing. Insulin resistance (InsR) seems to play a key role in a majority of phenotypes of these conditions, altering metabolic homeostasis, within muscle, liver, adipose and other tissues. Hyperinsulinemia is often associated with InsR and causes hormonal imbalances especially within ovaries and adrenals. Inositol is a polyalcohol, naturally occurring as nine stereoisomers, including D-chiro-inositol (DCI) and myo-inositol (MI), which have prominent roles in the metabolism of glucose and free fatty acids. MI and DCI have been classified as insulin-sensitizers and seem to adequately counteract several InsR-related metabolic alterations with a safe nutraceutical profile. Based on our analysis of selected studies that investigated MI and/or DCI, we conclude that supplementation with MI and/or DCI complement each other in their metabolic actions and act in synergy with other insulin sensitizing drugs and/or nutraceuticals. Nevertheless, considering the possible severe bias due to different methodologies across published studies, we conclude that there is a need for further studies on larger cohorts and with greater statistical power. These should further clarify outcomes and suitable therapeutic dosages of MI and DCI, possibly based on each patient's clinical status.
authors.affiliation: a Independent Nutrition Research Consultant , Los Angeles, CA , USA .
authors.forename: Cristiana
authors.initials: C
authors.lastname: Paul
authors.affiliation: b Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina , Messina , Italy .
authors.forename: Antonio Simone
authors.initials: AS
authors.lastname: Laganà
authors.affiliation: c Department of Obstetrics, Gynecology and Urology, Sant'Andrea Hospital , Sapienza University of Rome , Rome , Italy , and.
authors.forename: Paolo
authors.initials: P
authors.lastname: Maniglio
authors.affiliation: b Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina , Messina , Italy .
authors.forename: Onofrio
authors.initials: O
authors.lastname: Triolo
authors.affiliation: d Human Nutrition Institute, University of Bridgeport , Bridgeport, CT , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Brady
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007294:Inositol / Q000493:pharmacokinetics / Q000494:pharmacology*; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000188:drug therapy*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D014803:Vitamin B Complex; D007294:Inositol
keywords: Diabetes; insulin; insulin resistance; insulin sensitizer; polycystic ovary syndrome