A comparative study between Myo-inositol and metformin in the treatment of insulin-resistant women

OBJECTIVE: Insulin resistance (IR) is a common disorder, which can impair female fertility and is characterized by phenotypic heterogeneity. Lifestyle treatment and insulin sensitizers are commonly used in the management of women with IR and consequent hyperinsulinemia, in order to restore the normal endocrinological and clinical parameters. Metformin (MET) is considered one of the first approaches to this pathology but new evidences are showing promising results using Myo-inositol (MYO) in the management of this pathology.

The aim of this retrospective data analysis was to evaluate the therapeutic efficacy of MYO (4 g Myo-inositol plus 400 mcg folic acid/day) versus MET (on average 1225 mg/day) treatment in a heterogeneous group of IR patients. The focus was on progesterone and prolactin levels, menstrual cycle disorders, pregnancy rates, serum fasting glucose and insulin levels.

PATIENTS AND METHODS: Records about 6 months treatment (MYO or MET or both insulin sensitizers) at 237 women in reproductive age were analyzed retrospectively. The patients showed symptoms of IR without diabetes or pre diabetes.

RESULTS: All the groups showed a significant improvement (p<0.05) in prolactin and progesterone level after the treatment. Furthermore, the treated groups reported a significant improvement in the menstrual cycle disorders, while the only life-style group showed an increase but not statistically significant (p>0.05).

CONCLUSIONS: MYO and MET, associated with lifestyle, had both significant beneficial effects on serum progesterone and prolactin levels, menstrual cycle disorders and pregnancy rates in patients without severe carbohydrate metabolism malfunctions. Nevertheless, no significant differences were found between the MET and the MYO groups. Significant results in hormone levels and symptoms were reached with the combination of both treatments, whereas fasting serum insulin levels were slightly improved. Furthermore, the body mass index (BMI) was moderately but not significantly higher in MET and MET+MYO group.

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