Metabolism and ovarian function in PCOS women: a therapeutic approach with inositols

Polycystic ovary syndrome (PCOS) is characterized by chronical anovulation and hyperandrogenism which may be present in adifferent degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome andthe failure of inositol-mediated signaling may concur to them. Myo (MI) and D-chiro-inositol (DCI), the most studied inositolisoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan andMI-phosphoglycan control key enzymeswere involved in glucose and lipid metabolism. In form of phosphoinositides, they play an important role as second messengers inseveral cellular biological functions. Considering the key role played by insulin-resistance and androgen excess in PCOS patients,the insulin-sensitizing effects of bothMI andDCIwere tested in order to ameliorate symptoms and signs of this syndrome, includingthe possibility to restore patients’ fertility. Accumulating evidence suggests that both isoforms of inositol are effective in improvingovarian function and metabolism in patients with PCOS, although MI showed the most marked effect on the metabolic profile,whereas DCI reduced hyperandrogenism better. The purpose of this review is to provide an update on inositol signaling andcorrelate data on biological functions of these multifaceted molecules, in view of a rational use for the therapy in women withPCOS.