Myoinositol Therapy May Adjust the Metabolic Deregulation in Infertile PCOS Women through Modulation of the TyG Index-BMI: A Comparative Study versus Metformin

Sakr, Basma E.; Khamis, Afaf F.

doi:10.21608/svuijm.2025.419504.2267

Myoinositol Therapy May Adjust the Metabolic Deregulation in Infertile PCOS Women through Modulation of the TyG Index-BMI: A Comparative Study versus Metformin

Document Type : Original research articles

Authors

Basma E. Sakr ¹
Afaf F. Khamis ²

¹ Department of Obstetrics & Gynecology, Faculty of Medicine, Benha University, Benha, Egypt.

² Department of Clinical Pathology, Faculty of Medicine, Benha University, Benha, Egypt.

10.21608/svuijm.2025.419504.2267

Abstract

Background: Polycystic ovary syndrome (PCOS) affects women of childbearing age and is characterized by insulin resistance (IR). Myoinositol has insulin-mimetic, anti-diabetic, and lipid-lowering properties.
Objectives: Evaluating the effect of 6-month insulin sensitizer therapy on IR, glucose tolerance, and hormonal parameters.
Patients and methods: A total of 156 women with PCOS were evaluated to determine their body mass index (BMI) and the homeostatic model assessment of IR (HOMA-IR) index. Blood samples were obtained before and 6 months after treatment to estimate fasting plasma triglycerides to calculate the TyG index and TyG index-BMI and serum total testosterone (TT). Patients received metformin (MET) 500 mg three times/ day or myoinositol/d-chiro-inositol combination (MYO/DCI; 40:1) twice/day for 6 months.
Results: 65 women had regular menstrual patterns, and 15 women seeking pregnancy got pregnant with comparable intergroup differences. BMI, BG, TyG index, and TyG index-BMI measures were significantly (P<0.001) decreased in the MYO/DCI arm. Manifestations of hyperandrogenemia (HA) highly improved in both groups. A high percentage of decrease in HOMA-IR (β=0.202, P = 0.007) and serum TT (β=0.287, P < 0.001) were effective factors for resumption of normal menstrual pattern. High percentage of decrease in TyG Index-BMI was valuable predictor (β = 0.447, P < 0.001) for decreased IR.
Conclusion: MYO/DCI is effective therapy for PCOS, especially for those with obese phenotype. MYO/DCI combination provided reductions of HA manifestations and allowed the resumption of regular menstrual patterns and improved fertility. The TyG index-BMI is a good surrogate marker for improved metabolic homeostasis.

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