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Effects of Myo-inositol in Women With Polycystic Ovary Syndrome

Not Applicable
Completed
Conditions
Resistance, Insulin
Glucose Intolerance
Polycystic Ovary Syndrome
Interventions
Registration Number
NCT04892186
Lead Sponsor
University of Sao Paulo General Hospital
Brief Summary

The study will be carried out at the hospital of the medical school of sao paulo (HC-FMUSP) and the goal is to compare the effects of the administration of myo-inositol in relation to the effects of metformin in women with Polycystic Ovary Syndrome and insulin resistance or glucose intolerance. Menstrual cycle, hyperandrogenism, chronic inflammatory process, carbohydrate metabolism, hepatic steatosis will be evaluated. In total, 60 women in the reproductive period, with a variable age between 18 and 36 years old will be recruited and randomized in two groups: intervention- myo-inositol for 6 months, control group will use metformin also for 6 months.

Detailed Description

The study will involve 60 women in the reproductive period, with a variable between 19 and 36 years old and diagnosed with polycystic ovary syndrome (PCOS), according to Rotterdam- European Society of Human Reproduction and Embryology (ESHRE) / American Society for Reproductive Medicine (ASRM) criteria defined in 2003 and revised in 2018, and insulin resistance (presence acanthosis nigricans) or glucose intolerance (fasting glycemia, glycated hemoglobin or 75g glycemic overload and blood glucose assessment after 2 hours). It is a comparative and non-inferiority study of myo-inositol in relation to metformin. They will be divided into two groups of 30 patients: Group I (control) - they will receive metformin 850 mg, orally, twice a day; Group II (experiment) - they will receive myo-inositol 2g + folic acid 200mcg, orally, twice a day.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
60
Inclusion Criteria
  • Women aged 19 to 36 with diagnosis of PCOS and insulin resistance or glucose intolerance.
Exclusion Criteria
  • Previous use of any hormonal treatment in the past three months;
  • Other causes of anovulation;
  • Gynecological or other associated conditions (endometriosis, adenomyosis or diabetes mellitus);
  • FSH (Follicle Stimulating Hormone) > 15 Ul / L (2nd to 5th day of the cycle);
  • Beta-hcG (human chorionic gonadotropin) positive (pregnancy).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MetforminMetformin30 women with resistance insulin or glucose intolerance will receive metformin 850 mg, orally, twice a day for 6 months
Myo-inositolMyo-inositol30 women with resistance insulin or glucose intolerance will receive myo-inositol 2g + folic acid 200mcg, orally, twice a day for 6 months.
Primary Outcome Measures
NameTimeMethod
Menstrual cycle6 months

Analysis of period calendar.

Change in Abdominal Circumference and Hip CircumferenceEvery 3 months for up to 6 months

Abdominal circumference and hip circumference (measured in centimeters) will be assessed every 3 months.

Change in body mass indexEvery 3 months for up to 6 months

Body mass index (kg/m2) will be assessed every 3 months.

Change in glycated hemoglobinEvery 3 months for up to 6 months

Glycated hemoglobin will be performed every 3 months.

Change in antral follicle count6 months

Ultrasound of the ovaries will be done before and after treatment for antral follicle count (all follicles from 2 to 9 mm will be measured)

Change in glucose metabolismEvery 3 months for up to 6 months

Glucose tolerance curve with insulin curve will be performed every 3 months.

Change in ultrasound of the ovaries6 months

Transvaginal ultrasound to assess ovarian volume (measured in cubic centimeters) will be done before and after treatment.

Change in body weight in kilogramsEvery 3 months for up to 6 months

Patients will be weighed every 3 months (measured in kilograms).

Secondary Outcome Measures
NameTimeMethod
Hormonal dosage (FSH, LH, progesterone, estradiol)6 months

Hormonal dosage (FSH - Follicle-stimulating hormone, LH - luteinizing hormone, progesterone, estradiol) will be preformed before and after treatment.

Homocysteine6 months

Serum homocysteine dosage will be done before and after treatment to help assess a chronic inflammatory process.

Change in Lipid ProfileEvery 3 months for up to 6 months

Serum dosage of the lipid profile (high density lipoprotein - HDL, low density lipoprotein - LDL , very low density lipoprotein - VLDL, triglycerides, total cholesterol) will be done every 3 months

Hepatic steatosis6 months

Initial liver ultrasound will be done and repeated after 6 months of treatment to assess the presence or absence of hepatic steatosis and classify it as mild (grade 1), moderate (grade 2) and severe (grade 3).

Chronic inflammatory process6 months

Chronic inflammatory markers will be accessed by analyzing RNA messenger from cervical-vaginal cytology before and after treatment.

Modified Ferriman-Gallwey Score6 months

Modified Ferriman-Gallwey Score will be performed before and after treatment and patients with a score above 7 will be considered hirsute.

Assess adherence to treatment.Every 3 months for up to 6 months

Medication use diary will be delivered and will be reviewed every 3 months to assess adherence to treatment (good adherence will be considered use of more than 80% of the medication provided).

Side effectsEvery 3 months for up to 6 months

Questionnaire will be carried out every 3 months for patient to describe the 3 main side effects and how much they have hindered the treatment or not.

Liver enzymes6 months

Liver enzymes (aspartate aminotransferase, alanine aminotransferase,alkaline phosphatase) will be collected before and after treatment

C-reactive protein6 months

Chronic inflammatory process will be also evaluated by serum measurement of c-reactive protein before and after treatment.

Trial Locations

Locations (2)

Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo

🇧🇷

Sao Paulo, Brazil

Hospital Das Clinicas - Fmusp

🇧🇷

Sao Paulo, Brazil

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