Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS.
Vittorio UnferSimona DinicolaAntonio Simone LaganàMariano BizzarriPublished in: International journal of molecular sciences (2020)
The presence of abnormal ovarian ratios of myo-inositol (MI) to D-chiro-inositol (DCI) is a recurrent feature in PCOS. Available evidence suggests that MI and DCI may modulate steroid biosynthesis, likely in an opposite manner. Specifically, MI seems to induce estrogen production, while DCI has a role in the synthesis of androgens. Elevated insulin levels, generally associated with PCOS, alter the physiological MI/DCI ratio, increasing MI-to-DCI conversion through activation of a specific epimerase enzyme. DCI directly increases testosterone biosynthesis in thecal cells and reduces its conversion to estradiol by downregulating aromatase enzyme in granulosa cells. This manuscript reviews the literature that supports the connection between altered MI/DCI ratios and pathological steroidogenesis observed in PCOS women. Furthermore, it discusses the application of inositol-based treatment protocols in managing PCOS symptoms and improving the quality of patients' life.
Keyphrases
- polycystic ovary syndrome
- insulin resistance
- induced apoptosis
- cell cycle arrest
- end stage renal disease
- type diabetes
- ejection fraction
- newly diagnosed
- chronic kidney disease
- systematic review
- signaling pathway
- machine learning
- prognostic factors
- skeletal muscle
- estrogen receptor
- metabolic syndrome
- cell proliferation
- peritoneal dialysis
- deep learning
- adipose tissue
- randomized controlled trial
- cell wall
- depressive symptoms
- patient reported outcomes
- patient reported
- combination therapy