ObjectivePCOS is a syndrome is characterized by 2 out of 3 of the criteria established during the Rotterdam Consensus Conference. Recently the issue of
insulin resistance (IR) has caught attention.SubjectsA group of
overweight/obese PCOS patients (n = 30) have been evaluated before and after 3 months of daily integrative administration of d-
chiro inositol (DCI) (500 mg) and
alpha lipoic acid (ALA) (300 mg).MethodsHormonal and metabolic profiles, oral
glucose tolerance test (OGTT) for
glucose,
insulin and
C-peptide response were performed in baseline conditions and after DCI plus ALA treatment. Hepatic
Insulin Extraction (HIE) index was computed along the OGTT to evaluate the liver ability in degrading
insulin.ResultsThe treatment decreased LH,
Androstenedione (A),
insulin plasma levels, BMI, HOMA index, AST and ALT. Considering patients for the presence (n = 17) or absence of familial diabetes (n = 13), the greatest improvements occurred in the former patients.
Insulin response to OGTT was greatly reduced after the treatment interval in PCOS with familial diabetes. HIE computation disclosed that in presence of familial diabetes liver degradation of
insulin is reduced thus leaving a higher amount of circulating
insulin. DCI plus ALA administration decreased AST and ALT and restored hepatic
insulin clearance since HIE profile was improved.ConclusionOur study demonstrates that in
overweight/obese PCOS the predisposition to familial diabetes triggers IR not only through the endogenous impaired DCI and ALA synthesis but also through a reduced hepatic clearance of
insulin. DCI plus ALA administration positively improved hormonal, metabolic profiles as well as liver function.