Comparison of myo-inositol and metformin on glycemic control, lipid profiles and gene expression related to insulin and lipid metabolism in PCOS women: arandomized controlled clinical trial

Background and Aim : This investigation was conducted to evaluate comparison of myo-inositol andmetformin on glycemic control, lipid profiles and gene expression related to insulin and lipid metabolismin women with polycystic ovary syndrome (PCOS).Methods : This randomized controlled trial was conducted on 53 women with PCOS, aged 18-40 yearsold. Subjects were randomly allocated into two groups to take either myo-inositol (n=26) or metformin(n=27) for 12 weeks. Glycemic control and lipid profiles were determined at baseline and after the 12-weekintervention. Gene expression related to insulin and lipid metabolism was done on peripheral bloodmononuclear cells (PBMCs) of PCOS women using RT-PCR method.Results : Myo-inositol supplementation, compared with metformin, significantly reduced fasting plasmaglucose ( -5.12 mg/dL; 95% CI, -8.09, -2.16; P=0.001), serum insulin levels ( -1.49 μIU/mL; 95% CI, -2.28, -0.70; P<0.001), homeostasis model of assessment-insulin resistance ( -0.36; 95% CI, -0.55, -0.17;P<0.001), serum triglycerides ( 12.42 mg/dL; 95% CI, -20.47, -4.37; P=0.003) and VLDL-cholesterollevels ( -2.48 mg/dL; 95% CI, -4.09, -0.87; P=0.003), and significantly increased the quantitative insulinsensitivity check index ( 0.006; 95% CI, 0.002, 0.01; P=0.006) compared with metformin. Moreover, myoinositolsupplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma(PPAR- ) (P=0.002) compared with metformin.Conclusion : Overall, taking myo-inositol, compared with metformin, for 12 weeks by women with PCOShad beneficial effects on glycemic control, triglycerides and VLDL-cholesterol levels, and gene expressionof PPAR-γ.

Keywords:

Myo-inositol , metformin , glycemic control , lipid profiles , polycystic ovary syndrome