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Перспективы использования мио-инозитола в предгравидарной подготовке женщин с поликистозом яичников и инсулинорезистентностью
Перспективы использования мио-инозитола в предгравидарной подготовке женщин с поликистозом яичников и инсулинорезистентностью
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Аннотация
Синдром поликистозных яичников (СПКЯ) – основная причина бесплодия, связанная с метаболической и гормональной дисфункцией яичников. Синдром коморбиден инсулинорезистентности и существенно повышает риск гиперплазии эндометрия, ожирения, рака молочной железы, инфаркта миокарда и инсульта. Женщины с поликистозом яичников имеют повышенный риск ановуляторного цикла, бесплодия и невынашивания.
Перспективным нутрициальным направлением в составе комплексной терапии СПКЯ является использование мио-инозитола. Проведенный в настоящей работе систематический анализ показал, что прием внутрь мио-инозитола в дозировке 2–4 г/сут способствует снижению инсулинорезистентности, избыточной секреции андрогенов, риска гирсутизма и акне, нормализации липидного профиля и артериального давления, а также улучшению функционирования репродуктивной оси у пациенток с СПКЯ, нормализации овуляции и образованию зрелых ооцитов. Включение мио-инозитола в процесс подготовки к процедуре экстракорпорального оплодотворения позволяет существенно улучшить его результаты у пациенток с СПКЯ и другой патологией, ассоциированной с бесплодием.
Ключевые слова: мио-инозитол, поликистоз яичников, гиперинсулинемия, подготовка к ЭКО, Иноферт.
One of the promising nutricial directions in the complex treatment of PCOS is the use of myo-inositol. A systematic analysis presented in this paper, showed that oral administration of myo-inositol at a dose of 2-4 g/day helps to reduce insulin resistance, excessive androgen secretion, the risk of hirsutism and acne, normalization of lipid profile and blood pressure. Its reception improves functioning of the reproductive axis in patients with PCOS, normalizes ovulation and formation of mature oocytes. Inclusion of myo-inositol in the process of preparing for the procedure of in vitro fertilization (IVF) can significantly improve the results in patients with PCOS and other disorders associated with infertility.
Key words: myo-inositol, polycystic ovary syndrome, hyperinsulinemia , preparation for IVF, Inofert .
Перспективным нутрициальным направлением в составе комплексной терапии СПКЯ является использование мио-инозитола. Проведенный в настоящей работе систематический анализ показал, что прием внутрь мио-инозитола в дозировке 2–4 г/сут способствует снижению инсулинорезистентности, избыточной секреции андрогенов, риска гирсутизма и акне, нормализации липидного профиля и артериального давления, а также улучшению функционирования репродуктивной оси у пациенток с СПКЯ, нормализации овуляции и образованию зрелых ооцитов. Включение мио-инозитола в процесс подготовки к процедуре экстракорпорального оплодотворения позволяет существенно улучшить его результаты у пациенток с СПКЯ и другой патологией, ассоциированной с бесплодием.
Ключевые слова: мио-инозитол, поликистоз яичников, гиперинсулинемия, подготовка к ЭКО, Иноферт.
________________________________________________
One of the promising nutricial directions in the complex treatment of PCOS is the use of myo-inositol. A systematic analysis presented in this paper, showed that oral administration of myo-inositol at a dose of 2-4 g/day helps to reduce insulin resistance, excessive androgen secretion, the risk of hirsutism and acne, normalization of lipid profile and blood pressure. Its reception improves functioning of the reproductive axis in patients with PCOS, normalizes ovulation and formation of mature oocytes. Inclusion of myo-inositol in the process of preparing for the procedure of in vitro fertilization (IVF) can significantly improve the results in patients with PCOS and other disorders associated with infertility.
Key words: myo-inositol, polycystic ovary syndrome, hyperinsulinemia , preparation for IVF, Inofert .
Полный текст
Список литературы
1. Azziz R. Controversy in clinical endocrinology: diagnosis of polycystic ovarian syndrome: the Rotterdam criteria are premature. J Clin Endocrinol Metab 2006; 91 (3): 781–5.
2. Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci 2012; 16 (5): 575–81.
3. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012; 28 (7): 509–15.
4. Nestler JE, Jakubowicz DJ, Iuorno MJ. Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. J Pediatr Endocrinol Metab 2000; 13 (Suppl. 5): 1295–8.
5. Iuorno MJ, Jakubowicz DJ, Baillargeon JP et al. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocr Pract 2002; 8 (6): 417–23.
6. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004; 18 (5): 671–83.
7. Nafiye Y, Sevtap K, Muammer D et al.The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome. Fertil Steril 2010; 93 (6): 1864–9.
8. Saha L, Kaur S, Saha PK. Pharmacotherapy of polycystic ovary syndrome – an update. Fundam Clin Pharmacol 2012; 26 (1): 54–62.
9. Reynolds JEF. Martindale: The Extra Pharmacopoeia. 30. Pennsylvania: Rittenhouse Book Distributors. p. 1379. ISBN 0-85369-300-5. «An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man», 1993.
10. Громова О.А., Торшин И.Ю., Лиманова О.А. и др. Систематический анализ молекулярно-физиологических эффектов мио-инозитола – данные молекулярной биологии, экспериментальной и клинической медицины. Эффективная фармакотерапия в акушерстве и гинекологии. 2013; 8: 37–43.
11. Papaleo E, Unfer V, Baillargeon JP, Chiu TT. Contribution of myo-inositol to reproduction. Eur J Obstet Gynecol Reprod Biol 2009; 147 (2): 120–3.
12. Berridge MJ. Inositol trisphosphate and calcium signalling. Nature 1993; 361 (6410): 315–25.
13. Tesarik J, Sousa M. Mechanism of calcium oscillations in human oocytes: a two-store model. Mol Hum Reprod 1996; 2 (6): 383–6.
14. Goud PT, Goud AP, Leybaert L et al. Inositol 1, 4, 5-trisphosphate receptor function in human oocytes: calcium responses and oocyte activation-related phenomena induced by photolytic release of InsP (3) are blocked by a specific antibody to the type I receptor. Mol Hum Reprod 2002; 8 (10): 912–8.
15. Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci 2011; 15 (8): 931–6.
16. Musacchio MC, Cappelli V, Di Sabatino A et al. Evaluation of the myo-inositol-monacolin K association on hyperandrogenism and on the lipidic metabolism parameters in PCOS women. Minerva Ginecol 2013; 65 (1): 89–97.
17. Corrado F, D'Anna R, Di Vieste G et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 2011; 28 (8): 972–5.
18. Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci 2013; 17 (4): 537–40.
19. Genazzani AD, Prati A, Santagni S et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012; 28 (12): 969–73.
20. D'Anna R, Di Benedetto V, Rizzo P et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol 2012; 28 (6): 440–2.
21. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol 2010; 26 (4): 275–80.
22. De Leo V, La Marca A, Cappelli V et al. Evaluation of the treatment with D-chiroi-nositol on levels of oxidative stress in pcos patients. Minerva Ginecol 2012; 64 (6): 531–8.
23. Yen HW, Jakimiuk AJ, Munir I, Magoffin DA. Selective alterations in insulin receptor substrates-1, -2 and -4 in theca but not granulosa cells from polycystic ovaries. Mol Hum Reprod 2004; 10 (7): 473–9.
24. Nestler JE, Jakubowicz DJ, de Vargas AF et al. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 1998; 83 (6): 2001–5.
25. Munir I, Yen HW, Geller DH et al. Insulin augmentation of 17alpha-hydroxylase activity is mediated by phosphatidyl inositol 3-kinase but not extracellular signal-regulated kinase-1/2 in human ovarian theca cells. Endocrinology 2004; 145 (1): 175–83.
26. Zacche MM, Caputo L, Filippis S et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009; 25 (8): 508–13.
27. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci 2009; 13 (2): 105–10.
28. Dona G, Sabbadin C, Fiore C et al. Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome. Eur J Endocrinol 2012; 166 (4): 703–10.
29. Artini PG, Di Berardino OM, Papini F et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29 (4): 375–9.
30. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003; 7 (6): 151–9.
31. Venturella R, Mocciaro R, de Trana E et al. Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol 2012; 64 (3): 239–43.
32. Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Arch Gynecol Obstet 2013.
33. Papaleo E, Unfer V, Baillargeon JP et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Fertil Steril 2009; 91 (5): 1750–4.
34. Ciotta L, Stracquadanio M, Pagano I et al. Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011; 15 (5): 509–14.
35. Condorelli RA, La Vignera S, Di Bari F et al. Effects of myoinositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci 2011; 15 (2): 129–34.
36. Condorelli RA, La Vignera S, Bellanca S et al. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology 2012;
79 (6): 1290–5.
37. Lisi F, Carfagna P, Oliva MM et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod Biol Endocrinol 2012; 10: 52.
38. Sun TH, Heimark DB, Nguygen T et al. Both myo-inositol to chiro-inositol epimerase activities and chiro-inositol to myo-inositol ratios are decreased in tissues of GK type 2 diabetic rats compared to Wistar controls. Biochem Biophys Res Commun 2002; 293 (3): 1092–8.
39. Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res 2002; 3 (1): 47–60.
40. Whiting L, Danaher RN, Ruggiero K. D-chiro-Inositol Attenuates Epinephrine-stimulated Hepatic Glucose Output in the Isolated Perfused Liver Independently of Insulin. Horm Metab Res 2013; 45 (5): 394–7.
41. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab Syndr Relat Disord 2010; 8 (2): 127–36.
42. Unfer V, Carlomagno G, Rizzo P et al. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Eur Rev Med Pharmacol Sci 2011; 15 (4): 452–7.
43. Papaleo E, Molgora M, Quaranta L et al. Myo-inositol products in polycystic ovary syndrome (PCOS) treatment: quality, labeling accuracy, and cost comparison. Eur Rev Med Pharmacol Sci 2011; 15 (2): 165–74.
2. Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci 2012; 16 (5): 575–81.
3. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012; 28 (7): 509–15.
4. Nestler JE, Jakubowicz DJ, Iuorno MJ. Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. J Pediatr Endocrinol Metab 2000; 13 (Suppl. 5): 1295–8.
5. Iuorno MJ, Jakubowicz DJ, Baillargeon JP et al. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocr Pract 2002; 8 (6): 417–23.
6. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004; 18 (5): 671–83.
7. Nafiye Y, Sevtap K, Muammer D et al.The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome. Fertil Steril 2010; 93 (6): 1864–9.
8. Saha L, Kaur S, Saha PK. Pharmacotherapy of polycystic ovary syndrome – an update. Fundam Clin Pharmacol 2012; 26 (1): 54–62.
9. Reynolds JEF. Martindale: The Extra Pharmacopoeia. 30. Pennsylvania: Rittenhouse Book Distributors. p. 1379. ISBN 0-85369-300-5. «An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man», 1993.
10. Громова О.А., Торшин И.Ю., Лиманова О.А. и др. Систематический анализ молекулярно-физиологических эффектов мио-инозитола – данные молекулярной биологии, экспериментальной и клинической медицины. Эффективная фармакотерапия в акушерстве и гинекологии. 2013; 8: 37–43.
11. Papaleo E, Unfer V, Baillargeon JP, Chiu TT. Contribution of myo-inositol to reproduction. Eur J Obstet Gynecol Reprod Biol 2009; 147 (2): 120–3.
12. Berridge MJ. Inositol trisphosphate and calcium signalling. Nature 1993; 361 (6410): 315–25.
13. Tesarik J, Sousa M. Mechanism of calcium oscillations in human oocytes: a two-store model. Mol Hum Reprod 1996; 2 (6): 383–6.
14. Goud PT, Goud AP, Leybaert L et al. Inositol 1, 4, 5-trisphosphate receptor function in human oocytes: calcium responses and oocyte activation-related phenomena induced by photolytic release of InsP (3) are blocked by a specific antibody to the type I receptor. Mol Hum Reprod 2002; 8 (10): 912–8.
15. Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci 2011; 15 (8): 931–6.
16. Musacchio MC, Cappelli V, Di Sabatino A et al. Evaluation of the myo-inositol-monacolin K association on hyperandrogenism and on the lipidic metabolism parameters in PCOS women. Minerva Ginecol 2013; 65 (1): 89–97.
17. Corrado F, D'Anna R, Di Vieste G et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 2011; 28 (8): 972–5.
18. Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci 2013; 17 (4): 537–40.
19. Genazzani AD, Prati A, Santagni S et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012; 28 (12): 969–73.
20. D'Anna R, Di Benedetto V, Rizzo P et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol 2012; 28 (6): 440–2.
21. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol 2010; 26 (4): 275–80.
22. De Leo V, La Marca A, Cappelli V et al. Evaluation of the treatment with D-chiroi-nositol on levels of oxidative stress in pcos patients. Minerva Ginecol 2012; 64 (6): 531–8.
23. Yen HW, Jakimiuk AJ, Munir I, Magoffin DA. Selective alterations in insulin receptor substrates-1, -2 and -4 in theca but not granulosa cells from polycystic ovaries. Mol Hum Reprod 2004; 10 (7): 473–9.
24. Nestler JE, Jakubowicz DJ, de Vargas AF et al. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 1998; 83 (6): 2001–5.
25. Munir I, Yen HW, Geller DH et al. Insulin augmentation of 17alpha-hydroxylase activity is mediated by phosphatidyl inositol 3-kinase but not extracellular signal-regulated kinase-1/2 in human ovarian theca cells. Endocrinology 2004; 145 (1): 175–83.
26. Zacche MM, Caputo L, Filippis S et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009; 25 (8): 508–13.
27. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci 2009; 13 (2): 105–10.
28. Dona G, Sabbadin C, Fiore C et al. Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome. Eur J Endocrinol 2012; 166 (4): 703–10.
29. Artini PG, Di Berardino OM, Papini F et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29 (4): 375–9.
30. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003; 7 (6): 151–9.
31. Venturella R, Mocciaro R, de Trana E et al. Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol 2012; 64 (3): 239–43.
32. Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Arch Gynecol Obstet 2013.
33. Papaleo E, Unfer V, Baillargeon JP et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Fertil Steril 2009; 91 (5): 1750–4.
34. Ciotta L, Stracquadanio M, Pagano I et al. Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011; 15 (5): 509–14.
35. Condorelli RA, La Vignera S, Di Bari F et al. Effects of myoinositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci 2011; 15 (2): 129–34.
36. Condorelli RA, La Vignera S, Bellanca S et al. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology 2012;
79 (6): 1290–5.
37. Lisi F, Carfagna P, Oliva MM et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod Biol Endocrinol 2012; 10: 52.
38. Sun TH, Heimark DB, Nguygen T et al. Both myo-inositol to chiro-inositol epimerase activities and chiro-inositol to myo-inositol ratios are decreased in tissues of GK type 2 diabetic rats compared to Wistar controls. Biochem Biophys Res Commun 2002; 293 (3): 1092–8.
39. Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res 2002; 3 (1): 47–60.
40. Whiting L, Danaher RN, Ruggiero K. D-chiro-Inositol Attenuates Epinephrine-stimulated Hepatic Glucose Output in the Isolated Perfused Liver Independently of Insulin. Horm Metab Res 2013; 45 (5): 394–7.
41. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab Syndr Relat Disord 2010; 8 (2): 127–36.
42. Unfer V, Carlomagno G, Rizzo P et al. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Eur Rev Med Pharmacol Sci 2011; 15 (4): 452–7.
43. Papaleo E, Molgora M, Quaranta L et al. Myo-inositol products in polycystic ovary syndrome (PCOS) treatment: quality, labeling accuracy, and cost comparison. Eur Rev Med Pharmacol Sci 2011; 15 (2): 165–74.
2. Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci 2012; 16 (5): 575–81.
3. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012; 28 (7): 509–15.
4. Nestler JE, Jakubowicz DJ, Iuorno MJ. Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. J Pediatr Endocrinol Metab 2000; 13 (Suppl. 5): 1295–8.
5. Iuorno MJ, Jakubowicz DJ, Baillargeon JP et al. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocr Pract 2002; 8 (6): 417–23.
6. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004; 18 (5): 671–83.
7. Nafiye Y, Sevtap K, Muammer D et al.The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome. Fertil Steril 2010; 93 (6): 1864–9.
8. Saha L, Kaur S, Saha PK. Pharmacotherapy of polycystic ovary syndrome – an update. Fundam Clin Pharmacol 2012; 26 (1): 54–62.
9. Reynolds JEF. Martindale: The Extra Pharmacopoeia. 30. Pennsylvania: Rittenhouse Book Distributors. p. 1379. ISBN 0-85369-300-5. «An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man», 1993.
10. Громова О.А., Торшин И.Ю., Лиманова О.А. и др. Систематический анализ молекулярно-физиологических эффектов мио-инозитола – данные молекулярной биологии, экспериментальной и клинической медицины. Эффективная фармакотерапия в акушерстве и гинекологии. 2013; 8: 37–43.
11. Papaleo E, Unfer V, Baillargeon JP, Chiu TT. Contribution of myo-inositol to reproduction. Eur J Obstet Gynecol Reprod Biol 2009; 147 (2): 120–3.
12. Berridge MJ. Inositol trisphosphate and calcium signalling. Nature 1993; 361 (6410): 315–25.
13. Tesarik J, Sousa M. Mechanism of calcium oscillations in human oocytes: a two-store model. Mol Hum Reprod 1996; 2 (6): 383–6.
14. Goud PT, Goud AP, Leybaert L et al. Inositol 1, 4, 5-trisphosphate receptor function in human oocytes: calcium responses and oocyte activation-related phenomena induced by photolytic release of InsP (3) are blocked by a specific antibody to the type I receptor. Mol Hum Reprod 2002; 8 (10): 912–8.
15. Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci 2011; 15 (8): 931–6.
16. Musacchio MC, Cappelli V, Di Sabatino A et al. Evaluation of the myo-inositol-monacolin K association on hyperandrogenism and on the lipidic metabolism parameters in PCOS women. Minerva Ginecol 2013; 65 (1): 89–97.
17. Corrado F, D'Anna R, Di Vieste G et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 2011; 28 (8): 972–5.
18. Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci 2013; 17 (4): 537–40.
19. Genazzani AD, Prati A, Santagni S et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012; 28 (12): 969–73.
20. D'Anna R, Di Benedetto V, Rizzo P et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol 2012; 28 (6): 440–2.
21. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol 2010; 26 (4): 275–80.
22. De Leo V, La Marca A, Cappelli V et al. Evaluation of the treatment with D-chiroi-nositol on levels of oxidative stress in pcos patients. Minerva Ginecol 2012; 64 (6): 531–8.
23. Yen HW, Jakimiuk AJ, Munir I, Magoffin DA. Selective alterations in insulin receptor substrates-1, -2 and -4 in theca but not granulosa cells from polycystic ovaries. Mol Hum Reprod 2004; 10 (7): 473–9.
24. Nestler JE, Jakubowicz DJ, de Vargas AF et al. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 1998; 83 (6): 2001–5.
25. Munir I, Yen HW, Geller DH et al. Insulin augmentation of 17alpha-hydroxylase activity is mediated by phosphatidyl inositol 3-kinase but not extracellular signal-regulated kinase-1/2 in human ovarian theca cells. Endocrinology 2004; 145 (1): 175–83.
26. Zacche MM, Caputo L, Filippis S et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009; 25 (8): 508–13.
27. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci 2009; 13 (2): 105–10.
28. Dona G, Sabbadin C, Fiore C et al. Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome. Eur J Endocrinol 2012; 166 (4): 703–10.
29. Artini PG, Di Berardino OM, Papini F et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29 (4): 375–9.
30. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003; 7 (6): 151–9.
31. Venturella R, Mocciaro R, de Trana E et al. Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol 2012; 64 (3): 239–43.
32. Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Arch Gynecol Obstet 2013.
33. Papaleo E, Unfer V, Baillargeon JP et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Fertil Steril 2009; 91 (5): 1750–4.
34. Ciotta L, Stracquadanio M, Pagano I et al. Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011; 15 (5): 509–14.
35. Condorelli RA, La Vignera S, Di Bari F et al. Effects of myoinositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci 2011; 15 (2): 129–34.
36. Condorelli RA, La Vignera S, Bellanca S et al. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology 2012;
79 (6): 1290–5.
37. Lisi F, Carfagna P, Oliva MM et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod Biol Endocrinol 2012; 10: 52.
38. Sun TH, Heimark DB, Nguygen T et al. Both myo-inositol to chiro-inositol epimerase activities and chiro-inositol to myo-inositol ratios are decreased in tissues of GK type 2 diabetic rats compared to Wistar controls. Biochem Biophys Res Commun 2002; 293 (3): 1092–8.
39. Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res 2002; 3 (1): 47–60.
40. Whiting L, Danaher RN, Ruggiero K. D-chiro-Inositol Attenuates Epinephrine-stimulated Hepatic Glucose Output in the Isolated Perfused Liver Independently of Insulin. Horm Metab Res 2013; 45 (5): 394–7.
41. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab Syndr Relat Disord 2010; 8 (2): 127–36.
42. Unfer V, Carlomagno G, Rizzo P et al. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Eur Rev Med Pharmacol Sci 2011; 15 (4): 452–7.
43. Papaleo E, Molgora M, Quaranta L et al. Myo-inositol products in polycystic ovary syndrome (PCOS) treatment: quality, labeling accuracy, and cost comparison. Eur Rev Med Pharmacol Sci 2011; 15 (2): 165–74.
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2. Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci 2012; 16 (5): 575–81.
3. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012; 28 (7): 509–15.
4. Nestler JE, Jakubowicz DJ, Iuorno MJ. Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. J Pediatr Endocrinol Metab 2000; 13 (Suppl. 5): 1295–8.
5. Iuorno MJ, Jakubowicz DJ, Baillargeon JP et al. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocr Pract 2002; 8 (6): 417–23.
6. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004; 18 (5): 671–83.
7. Nafiye Y, Sevtap K, Muammer D et al.The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome. Fertil Steril 2010; 93 (6): 1864–9.
8. Saha L, Kaur S, Saha PK. Pharmacotherapy of polycystic ovary syndrome – an update. Fundam Clin Pharmacol 2012; 26 (1): 54–62.
9. Reynolds JEF. Martindale: The Extra Pharmacopoeia. 30. Pennsylvania: Rittenhouse Book Distributors. p. 1379. ISBN 0-85369-300-5. «An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man», 1993.
10. Громова О.А., Торшин И.Ю., Лиманова О.А. и др. Систематический анализ молекулярно-физиологических эффектов мио-инозитола – данные молекулярной биологии, экспериментальной и клинической медицины. Эффективная фармакотерапия в акушерстве и гинекологии. 2013; 8: 37–43.
11. Papaleo E, Unfer V, Baillargeon JP, Chiu TT. Contribution of myo-inositol to reproduction. Eur J Obstet Gynecol Reprod Biol 2009; 147 (2): 120–3.
12. Berridge MJ. Inositol trisphosphate and calcium signalling. Nature 1993; 361 (6410): 315–25.
13. Tesarik J, Sousa M. Mechanism of calcium oscillations in human oocytes: a two-store model. Mol Hum Reprod 1996; 2 (6): 383–6.
14. Goud PT, Goud AP, Leybaert L et al. Inositol 1, 4, 5-trisphosphate receptor function in human oocytes: calcium responses and oocyte activation-related phenomena induced by photolytic release of InsP (3) are blocked by a specific antibody to the type I receptor. Mol Hum Reprod 2002; 8 (10): 912–8.
15. Carlomagno G, Unfer V. Inositol safety: clinical evidences. Eur Rev Med Pharmacol Sci 2011; 15 (8): 931–6.
16. Musacchio MC, Cappelli V, Di Sabatino A et al. Evaluation of the myo-inositol-monacolin K association on hyperandrogenism and on the lipidic metabolism parameters in PCOS women. Minerva Ginecol 2013; 65 (1): 89–97.
17. Corrado F, D'Anna R, Di Vieste G et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 2011; 28 (8): 972–5.
18. Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci 2013; 17 (4): 537–40.
19. Genazzani AD, Prati A, Santagni S et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012; 28 (12): 969–73.
20. D'Anna R, Di Benedetto V, Rizzo P et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol 2012; 28 (6): 440–2.
21. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol 2010; 26 (4): 275–80.
22. De Leo V, La Marca A, Cappelli V et al. Evaluation of the treatment with D-chiroi-nositol on levels of oxidative stress in pcos patients. Minerva Ginecol 2012; 64 (6): 531–8.
23. Yen HW, Jakimiuk AJ, Munir I, Magoffin DA. Selective alterations in insulin receptor substrates-1, -2 and -4 in theca but not granulosa cells from polycystic ovaries. Mol Hum Reprod 2004; 10 (7): 473–9.
24. Nestler JE, Jakubowicz DJ, de Vargas AF et al. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 1998; 83 (6): 2001–5.
25. Munir I, Yen HW, Geller DH et al. Insulin augmentation of 17alpha-hydroxylase activity is mediated by phosphatidyl inositol 3-kinase but not extracellular signal-regulated kinase-1/2 in human ovarian theca cells. Endocrinology 2004; 145 (1): 175–83.
26. Zacche MM, Caputo L, Filippis S et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009; 25 (8): 508–13.
27. Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci 2009; 13 (2): 105–10.
28. Dona G, Sabbadin C, Fiore C et al. Inositol administration reduces oxidative stress in erythrocytes of patients with polycystic ovary syndrome. Eur J Endocrinol 2012; 166 (4): 703–10.
29. Artini PG, Di Berardino OM, Papini F et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29 (4): 375–9.
30. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003; 7 (6): 151–9.
31. Venturella R, Mocciaro R, de Trana E et al. Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol. Minerva Ginecol 2012; 64 (3): 239–43.
32. Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Arch Gynecol Obstet 2013.
33. Papaleo E, Unfer V, Baillargeon JP et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Fertil Steril 2009; 91 (5): 1750–4.
34. Ciotta L, Stracquadanio M, Pagano I et al. Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011; 15 (5): 509–14.
35. Condorelli RA, La Vignera S, Di Bari F et al. Effects of myoinositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci 2011; 15 (2): 129–34.
36. Condorelli RA, La Vignera S, Bellanca S et al. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology 2012;
79 (6): 1290–5.
37. Lisi F, Carfagna P, Oliva MM et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study. Reprod Biol Endocrinol 2012; 10: 52.
38. Sun TH, Heimark DB, Nguygen T et al. Both myo-inositol to chiro-inositol epimerase activities and chiro-inositol to myo-inositol ratios are decreased in tissues of GK type 2 diabetic rats compared to Wistar controls. Biochem Biophys Res Commun 2002; 293 (3): 1092–8.
39. Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res 2002; 3 (1): 47–60.
40. Whiting L, Danaher RN, Ruggiero K. D-chiro-Inositol Attenuates Epinephrine-stimulated Hepatic Glucose Output in the Isolated Perfused Liver Independently of Insulin. Horm Metab Res 2013; 45 (5): 394–7.
41. Baillargeon JP, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab Syndr Relat Disord 2010; 8 (2): 127–36.
42. Unfer V, Carlomagno G, Rizzo P et al. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. Eur Rev Med Pharmacol Sci 2011; 15 (4): 452–7.
43. Papaleo E, Molgora M, Quaranta L et al. Myo-inositol products in polycystic ovary syndrome (PCOS) treatment: quality, labeling accuracy, and cost comparison. Eur Rev Med Pharmacol Sci 2011; 15 (2): 165–74.
Авторы
О.А.Громова1, 2, Е.А. Гончарова2, 3, И.Ю.Торшин1, 2, О.А.Лиманова1, 2, Н.В.Керимкулова1
1. Российский сотрудничающий центр Института микроэлементов ЮНЕСКО, Москва;
2. ГБОУ ВПО Ивановская государственная медицинская академия Минздрава России;
3. Клиника эстетической медицины RHANA, Москва
1. Российский сотрудничающий центр Института микроэлементов ЮНЕСКО, Москва;
2. ГБОУ ВПО Ивановская государственная медицинская академия Минздрава России;
3. Клиника эстетической медицины RHANA, Москва
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