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

Abstract

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.

Keywords

• Polycystic ovary syndrome
• Inositol
• Lipoic acid
• Therapeutic agent

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

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.

Anahtar Kelimeler

• Polikistik over sendromu
• İnositol
• Lipoik asit
• Terapötik ajan

Kaynakça

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