Effect of Myo-Inositol Supplementation on Serum Adiponectin Levels and Insulin Resistance in Women having PMOS (PCOS)

Abstract

Background: Polymetabolic Endocrine Syndrome (PMOS) (previously known as Polycystic Ovary Syndrome PCOS) is a common endocrine-metabolic syndrome amongst reproductive aged women, particularly prevalent in South Asian women. Two of the main pathophysiological characteristics are hypoadiponectinemia and insulin resistance. Objectives: The aim of this study was to assess the therapeutic effect of administration of myo-inositol for 8-weeks (4g/day) along with life style changes on serum adiponectin and HOMA-IR in Pakistani women having PMOS. Methods: A parallel group-controlled design of 100 women (18-35 years) diagnosed with PMOS using modified NCEP ATP III criteria. After randomization 1:1 participant received myo-inositol (4g/day) and lifestyle advice (test group, n=50) or lifestyle advice alone (control group, n=50) for 8 weeks. The primary outcome was change in serum adiponectin level and the secondary outcomes were HOMA-IR, fasting glucose and fasting insulin. Results: The test group demonstrated significant adiponectin elevation (4.71±0.92 to 6.12±1.08 μg/mL, +30%, p<0.001, Cohen's d=1.42) versus controls (4.92±0.86 to 4.99±0.91 μg/mL, p=0.399). HOMA-IR reduced by 32% in the test group (4.58±1.38 to 3.12±1.29, p<0.001) versus minimal change in controls. The Inter-group effect sizes were large (adiponectin: d=2.29; HOMA-IR: d=1.64). Conclusion: Supplementation with myo-inositol in PMOS-related insulin resistance results in a dramatic improvement of adiponectin, and is an effective non-pharmacological adjunctive therapy.