2015 studies on d-chiro-inositol

Here are a few recent (though small) studies on d-chiro-inositol (DCI) for Polycystic Ovarian Syndrome (PCOS). They had promising results. This is good news.

However, this little taste of research on DCI only points out the gaps that still exist and sure leaves me wanting more. So here's my Christmas wish list for PCOS research.

• I would like to see some gold-standard randomized controlled studies with larger study groups. What's with all these little studies? It doesn't mean that much until it's been done with large study groups and replicated several times
• I'd like to see more research from the USA and other countries; why are the Italians the only ones really pursuing this so closely?
• I'd like to see more research done on how DCI affects metabolism, not just menstrual regularity, and whether it slows or prevents progression to Type II diabetes. It's really the metabolic implications that could have the most potential impact on people's health
• I want to know if there is any interaction between metformin and DCI
• I want to make sure DCI is safe in pregnancy and breastfeeding
• I'd like to see DCI studied in post-menopausal women too; that is a vastly understudied group for DCI. Does it impact the incidence of diabetes, heart disease, or stroke?
• I'd like to see DCI studied in close male relatives of women with PCOS. If PCOS women have a secondary messenger insulin signaling defect, wouldn't you think that our male relatives probably have it too? And that DCI might benefit them too?
• I'd like to see this question about which protocol is best (DCI vs. myo-inositol vs. both) settled with better quality research

Okay, I'm cranky and demanding, but with a PCOS medication that shows this much promise, isn't it about time we had larger, more complete, and more qualitative trials?

Come on, PCOS research community, get on the stick. Stop putting out these tiny little fluff studies and start cranking out some meaningful inositol research that starts answering the most critical questions.


References

Gynecol Endocrinol. 2015 Jan;31(1):52-6. doi: 10.3109/09513590.2014.964201. Epub 2014 Sep 30. The menstrual cycle regularization following D-chiro-inositol treatment in PCOS women: a retrospective study. La Marca A1, Grisendi V, Dondi G, Sighinolfi G, Cianci A. PMID: 25268566

Polycystic ovary syndrome is characterized by irregular cycles, hyperandrogenism, polycystic ovary at ultrasound and insulin resistance. The effectiveness of D-chiro-inositol (DCI) treatment in improving insulin resistance in PCOS patients has been confirmed in several reports. The objective of this study was to retrospectively analyze the effect of DCI on menstrual cycle regularity in PCOS women. This was a retrospective study of patients with irregular cycles who were treated with DCI. Of all PCOS women admitted to our centre, 47 were treated with DCI and had complete medical charts. The percentage of women reporting regular menstrual cycles significantly increased with increasing duration of DCI treatment (24% and 51.6% at a mean of 6 and 15 months of treatment, respectively). Serum AMH levels and indexes of insulin resistance significantly decreased during the treatment. Low AMH levels, high HOMA index, and the presence of oligomenorrhea at the first visit were the independent predictors of obtaining regular menstrual cycle with DCI. In conclusion, the use of DCI is associated to clinical benefits for many women affected by PCOS including the improvement in insulin resistance and menstrual cycle regularity. Responders to the treatment may be identified on the basis of menstrual irregularity and hormonal or metabolic markers.

Minerva Ginecol. 2015 Aug;67(4):321-5. Epub 2015 Feb 11. Myo-inositol vs. D-chiro inositol in PCOS treatment. Formuso C1, Stracquadanio M, Ciotta L. PMID: 25670222

AIM: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women in fertile age. It is an endocrine and metabolic disorder characterized by oligo-anovulation, hyperandrogenism and insulin-resistance. Various therapeutic approaches have been attempted in PCOS, including diet and the use of pharmacological agents such as oral contraceptives (OCs) or anti-androgens. Recently, the introduction of inositol in the treatment plan has proved to be as reasonable as useful in countering the endocrine-metabolic disorders of this syndrome. METHODS: The aim of our study was to compare the clinical, endocrine and metabolic response after 6 months of therapy in 137 PCOS women characterized by oligomenorrhea and/or acne and/or mild hirsutism and insulin-resistance. The patients were treated with myo-inositol or with D-chiro-inositol or with placebo. RESULTS: Our study showed that both myo-inositol (MI-PG) and D-chiro inositol (DCI-PG) treatments are able to significantly improve the regularity of the menstrual cycle, the Acne Score, the endocrine and metabolic parameters and the insulin-resistence in young, overweight, PCOS patients. CONCLUSION: Definitely, we assumed that both treatments with myo-inositol and with D-chiro inositol could be proposed as a potential valid therapeutic approach for the treatment of patients with PCOS. Additionally, further examination and for a longer period of treatment are needed.

Arch Gynecol Obstet. 2015 May;291(5):1181-6. doi: 10.1007/s00404-014-3552-6. Epub 2014 Nov 22. Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with D-Chiro-Inositol. Laganà AS1, Barbaro L, Pizzo A. PMID: 25416201

PURPOSE: To evaluate the effects of D-Chiro-Inositol in women affected by polycystic ovary syndrome (PCOS). METHODS: We enrolled 48 patients, with homogeneous bio-physical characteristics, affected by PCOS and menstrual irregularities. These patients underwent treatment with 1 gr of D-Chiro-Inositol/die plus 400 mcg of Folic Acid/die orally for 6 months. We analyzed pre-treatment and post-treatment BMI, Systolic and Diastolic blood pressure, Ferriman-Gallwey score, Cremoncini score, serum LH, LH/FSH ratio, total and free testosterone, DHEA-S, Δ-4-androstenedione, SHBG, prolactin, glucose/IRI ratio, HOMA index, and resumption of regular menstrual cycles. RESULTS: We evidenced a statistically significant reduction of systolic blood pressure, Ferriman-Gallwey score, LH, LH/FSH ratio, total Testosterone, free Testosterone, ∆-4-Androstenedione, Prolactin, and HOMA Index; in the same patients, we noticed a statistically significant increase of SHBG and Glycemia/IRI ratio. Moreover, we observed statistically significant (62.5%; p < 0.05) post-treatment menstrual cycle regularization. CONCLUSIONS: D-Chiro-Inositol is effective in improving ovarian function and metabolism of patients affected by PCOS.