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A Review on Inocytol and Lipoic Acid Reinforcement from Current Therapeutic Agents in Polycistic Over Syndrome

Yıl 2021, Cilt: 7 Sayı: 2, 184 - 196, 12.07.2021
https://doi.org/10.53394/akd.958775

Öz

Polycystic ovary syndrome (PCOS) is an endocrine disorder seen in women of reproductive age and
causes reproductive, hormonal and metabolic anomalies. Different therapeutic agents with insulin
sensitizing properties are also used for the treatment of PCOS due to the accompany of insulin
resistance (IR). Inositol with insulin sensitizing properties and alpha lipoic acid with antioxidant
properties are among these therapeutic agents. Inositol (myo-inositol and di-chiroinositol) is a dietary
supplement that plays a role in insulin signal transduction as a secondary messenger and has been
shown to be effective in the treatment of PCOS. Studies have reported that ovulation rate, menstrual
cycles and metabolic profiles in women with PCOS have improved with inositol supplementation. The
use of α-lipoic acid (ALA) for the treatment of PCOS and IR is also considered a possible therapeutic
approach. In addition to being a potent antioxidant, ALA can increase insulin sensitivity through
activation of the 5'-adenosine monophosphate-activated protein kinase (AMPK), which is a cellular
energy sensor that induces the translocation of glucose carrier 4 (GLUT4) into the plasma membrane
through an insulin-independent mechanism. For this reason, it is stated that ALA can increase insulin
sensitivity and reproductive functions and correct metabolic abnormalities in women with PCOS
by reducing oxidative stress. In recent studies, it was found that better results were obtained with
combined therapy compared to the individual supplementation of inositol and lipoic acid. In this
review, the effects of inositol and ALA separately and the combined treatment of both in PCOS were
investigated.

Kaynakça

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Polikistik Over Sendromunda Güncel Terapötik Ajanlardan İnositol ve Alfa Lipoik Asit Takviyesi Üzerine Bir Derleme

Yıl 2021, Cilt: 7 Sayı: 2, 184 - 196, 12.07.2021
https://doi.org/10.53394/akd.958775

Öz

Polikistik over sendromu (PKOS) üreme çağındaki kadınlarda görülen bir endokrin bozukluk olup,
üreme, hormonal ve metabolik anomalilere neden olur. İnsülin direncinin (İD) eşlik etmesi nedeniyle
PKOS tedavisi için insülin duyarlaştırıcı özelliği bulunan farklı terapötik ajanlar da kullanılmaktadır.
İnsülin duyarlaştırıcı özelliği bulunan inositol ve antioksidan özelliği olan alfa lipoik asit de bu
terapötik ajanlar arasında yer almaktadır. İnositol (myo-inositol ve di-chiroinositol), ikincil bir haberci
olarak insülin sinyal iletimi transdüksiyonunda rol alan ve PKOS tedavisinde etkili olduğu gösterilen
bir besin takviyesidir. Yapılan çalışmalar, inositol takviyesi ile PKOS'lu kadınlarda yumurtlama hızı,
adet döngüleri ve metabolik profillerinde düzelmeler olduğunu bildirmektedir. PKOS ve İD tedavisi
için α-lipoik asit (ALA) kullanımı da olası bir terapötik yaklaşım olarak kabul edilmektedir. ALA güçlü
bir antioksidan olmanın yanı sıra insülinden bağımsız bir mekanizma ile glikoz taşıyıcı 4'ün (GLUT4)
plazma zarına translokasyonunu indükleyen bir hücresel enerji sensörü olan 5’-adenosin monofosfatla
aktive edilen protein kinazın (AMPK) aktivasyonu yoluyla insülin duyarlılığını artırabilir. Bu nedenle
PKOS'lu kadınlarda ALA'nın oksidatif stresi azaltarak insülin duyarlılığını ve üreme fonksiyonlarını
artırabileceği ve metabolik anormallikleri düzeltebileceği belirtilmektedir. Son zamanlarda yapılan
çalışmalarda ise inositol ve lipoik asidin ayrı ayrı takviyesine oranla kombine tedavi ile daha iyi sonuçlar
alındığı bulunmuştur. Bu derlemede inositol ve ALA’nın ayrı ayrı ve ikisinin kombine tedavisinin
PKOS’taki etkisi incelenmiştir.

Kaynakça

  • 1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19-25.
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  • 72. Namazi N, Larijani B, Azadbakht L. Alpha-lipoic acid supplement in obesity treatment: A systematic review and meta-analysis of clinical trials. Clin Nutr 2018;37(2):419-28.
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  • 75. Genazzani AD, Shefer K, Della Casa D, Prati A, Napolitano A, Manzo A, Despini G, Simoncini T. Modulatory effects of alpha-lipoic acid (ALA) administration on insulin sensitivity in obese PCOS patients. J Endocrinol Invest 2018:41(5):583-590.
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  • 78. Eason R, Archer H, Akhtar S, Bailey CJ. Obesity, Metabolism. Lipoic acid increases glucose uptake by skeletal muscles of obese‐diabetic ob/ob mice. Diabetes Obes Metab 2002;4(1):29-35.
  • 79. Ghibu S, Richard C, Vergely C, Zeller M, Cottin Y, Rochette L. Antioxidant properties of an endogenous thiol: alpha-lipoic acid, useful in the prevention of cardiovascular diseases. J Cardiovasc Pharmacol 2009;54(5):391-8.
  • 80. Gomes MB, Negrato CA. Alpha-lipoic acid as a pleiotropic compound with potential therapeutic use in diabetes and other chronic diseases. Diabetol Metab Syndr 2014;6(1):80.
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  • 82. Konrad D, Somwar R, Sweeney G, Yaworsky K, Hayashi M, Ramlal T, Klip A. The antihyperglycemic drug α-lipoic acid stimulates glucose uptake via both GLUT4 translocation and GLUT4 activation: potential role of p38 mitogen-activated protein kinase in GLUT4 activation. Diabetes 2001;50(6):1464-71.
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  • 85. Genazzani AD, Despini G, Santagni S, Prati A, Rattighieri E, Chierchia E, Simoncini T. Effects of a combination of alpha lipoic acid and myo-inositol on insulin dynamics in overweight/obese patients with PCOS. Endocrinol Metab Synd 2014;3(3):1000140.
  • 86. Cappelli V, Di AS, Musacchio M, De VL. Evaluation of a new association between insulin-sensitizers and α-lipoic acid in obese women affected by PCOS. Minerva Ginecol 2013;65(4):425-33.
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  • 89. Morgante G, Cappelli V, Di AS, Massaro M, De VL. Polycystic ovary syndrome (PCOS) and hyperandrogenism: the role of a new natural association. Minerva Ginecol 2015;67(5):457-63.
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  • 92. Genazzani AD, Prati A, Santagni S, Ricchieri F, Chierchia E, Rattighieri E, Campedelli A, Simoncini T, Artini PG. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol 2012;28(12):969-73.
  • 93. Genazzani AD, Santagni S, Rattighieri E, Chierchia E, Despini G, Marini G, Prati A, Simoncini T. Modulatory role of D-chiro-inositol (DCI) on LH and insulin secretion in obese PCOS patients. Gynecol Endocrinol 2014;30(6):438-43.
  • 94. La Marca A, Grisendi V, Dondi G, Sighinolfi G, Cianci A. The menstrual cycle regularization following D-chiroinositol treatment in PCOS women: a retrospective study. Gynecol Endocrinol 2015;31(1):52-6.
  • 95. De Cicco S, Immediata V, Romualdi D, Policola C, Tropea A, Di Florio C, Tagliaferri V, Scarinci E, Della Casa S, Lanzone A, Apa R. Myoinositol combined with alpha-lipoic acid may improve the clinical and endocrine features of polycystic ovary syndrome through an insulinindependent action. Gynecol Endocrinol 2017;33(9):698-701.
  • 96. Genazzani AD, Prati A, Marchini F, Petrillo T, Napolitano A, Simoncini T. Differential insulin response to oral glucose tolerance test (OGTT) in overweight/obese polycystic ovary syndrome patients undergoing to myoinositol (MYO), alpha lipoic acid (ALA), or combination of both. Gynecol Endocrinol 2019:35(12):1088-93.
Toplam 96 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Derlemeler
Yazarlar

Selma Fırat 0000-0003-1477-2194

Mehmet Fisunoğlu 0000-0002-0021-7811

Yayımlanma Tarihi 12 Temmuz 2021
Gönderilme Tarihi 21 Ocak 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 7 Sayı: 2

Kaynak Göster

Vancouver Fırat S, Fisunoğlu M. Polikistik Over Sendromunda Güncel Terapötik Ajanlardan İnositol ve Alfa Lipoik Asit Takviyesi Üzerine Bir Derleme. Akd Tıp D. 2021;7(2):184-96.