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CARS Archives

D-Chiro-Inositol Deficiency and PCOS
Title:Ovulatory and Metabolic Effects of d-Chiro-Inositol in the Polycystic Ovary Syndrome
Author: J.E. Nestler et al.
Address: Richmond, Virginia
Source: New England Journal of Medicine 340: 1314-1320 (April) 1999
Summary: This randomized controlled study (Phase II) investigates whether women with polycystic ovary syndrome (PCOS) have insulin resistance and hyperinsulinemia because of a deficiency of a d-chiro-inositol-containing phosphoglycan that mediates the action of insulin. It was hypothesized that the administration of d-chiro-inositol would replenish stores of the mediator and improve insulin sensitivity. Laboratory measurements of steroids in serum and oral glucose-tolerance tests were performed on 44 obese study participants with PCOS. These measurements occurred before and after the oral administration of 1200 mg of d-chiro-inositol or placebo once daily for six to eight weeks. To monitor for ovulation, serum progesterone concentration was measured weekly. The 22 women given d-chiro-inositol, the mean (±SD) area under the plasma insulin curve after the oral administration of glucose decreased from 13,417±11,572 to 5158±6714 µU per milliliter per minute. Glucose tolerance did not change significantly. The serum free testosterone concentration in these 22 women decreased from 1.1±0.8 to 0.5±0.5 ng per deciliter .The women's diastolic and systolic blood pressure decreased by 4 mm Hg. and their plasma triglyceride concentrations decreased from 184±88 to 110±61 mg per deciliter. None of these variables showed significant change in the placebo group(n=22). Nineteen of the 22 women who received d-chiro-inositol ovulated, as compared with 6 of the 22 women in the placebo group. The authors concluded that "d-Chiro-inositol increases the action of insulin in patients with PCOS, thereby improving ovulatory function and decreasing serum androgen concentrations, blood pressure, and plasma triglyceride concentrations. "


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