Myoinositol Therapy May Adjust the Metabolic Deregulation in Infertile PCOS Women through Modulation of the TyG Index-BMI: A Comparative Study versus Metformin | ||
| SVU-International Journal of Medical Sciences | ||
| Volume 8, Issue 2, July 2025, Pages 556-571 PDF (409.8 K) | ||
| Document Type: Original research articles | ||
| DOI: 10.21608/svuijm.2025.419504.2267 | ||
| Authors | ||
| Basma E. Sakr* 1; Afaf F. Khamis2 | ||
| 1Department of Obstetrics & Gynecology, Faculty of Medicine, Benha University, Benha, Egypt. | ||
| 2Department of Clinical Pathology, Faculty of Medicine, Benha University, Benha, Egypt. | ||
| Abstract | ||
| Background: Polycystic ovary syndrome (PCOS) affects women of childbearing age and is characterized by insulin resistance (IR). Myoinositol has insulin-mimetic, anti-diabetic, and lipid-lowering properties. Objectives: Evaluating the effect of 6-month insulin sensitizer therapy on IR, glucose tolerance, and hormonal parameters. Patients and methods: A total of 156 women with PCOS were evaluated to determine their body mass index (BMI) and the homeostatic model assessment of IR (HOMA-IR) index. Blood samples were obtained before and 6 months after treatment to estimate fasting plasma triglycerides to calculate the TyG index and TyG index-BMI and serum total testosterone (TT). Patients received metformin (MET) 500 mg three times/ day or myoinositol/d-chiro-inositol combination (MYO/DCI; 40:1) twice/day for 6 months. Results: 65 women had regular menstrual patterns, and 15 women seeking pregnancy got pregnant with comparable intergroup differences. BMI, BG, TyG index, and TyG index-BMI measures were significantly (P<0.001) decreased in the MYO/DCI arm. Manifestations of hyperandrogenemia (HA) highly improved in both groups. A high percentage of decrease in HOMA-IR (β=0.202, P = 0.007) and serum TT (β=0.287, P < 0.001) were effective factors for resumption of normal menstrual pattern. High percentage of decrease in TyG Index-BMI was valuable predictor (β = 0.447, P < 0.001) for decreased IR. Conclusion: MYO/DCI is effective therapy for PCOS, especially for those with obese phenotype. MYO/DCI combination provided reductions of HA manifestations and allowed the resumption of regular menstrual patterns and improved fertility. The TyG index-BMI is a good surrogate marker for improved metabolic homeostasis. | ||
| Keywords | ||
| PCOS; Metformin; Myoinositol; Hyperandrogenemia; TyG Index | ||
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