Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial

Yan Li, Hongli Ma, Yuehui Zhang, Hongying Kuang, Ernest Hung Yu Ng, Lihui Hou, Xiaoke Wu, Yan Li, Hongli Ma, Yuehui Zhang, Hongying Kuang, Ernest Hung Yu Ng, Lihui Hou, Xiaoke Wu

Abstract

Background: Insulin resistance and hyperinsulinemia play a key role in the pathogenesis of polycystic ovary syndrome (PCOS), which is characterized by hyperandrogenism, ovulatory dysfunction, and presence of polycystic ovaries on pelvic scanning. Insulin resistance is significantly associated with the long-term risks of metabolic syndrome and cardiovascular disease. Berberine has effects on insulin resistance but its use in women with PCOS has not been fully investigated. In this paper, we present a research design evaluating the effects of berberine on insulin resistance in women with PCOS.

Methods/design: This is a multicenter, randomized, placebo-controlled and double-blind trial. A total of 120 patients will be enrolled in this study and will be randomized into two groups. Berberine or placebo will be taken orally for 12 weeks. The primary outcome is the whole body insulin action assessed with the hyperinsulinemic-euglycemic clamp.

Discussion: We postulate that women with PCOS will have improved insulin resistance following berberine administration.

Trial registration: This study is registered at ClinicalTrials.gov, NCT01138930.

Figures

Figure 1
Figure 1
Study flowchart.

References

    1. Balen A. Pathogenesis of polycystic ovary syndrome–the enigma unravels? Lancet. 1999;354:966–967.
    1. Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med. 2006;12:324–332.
    1. Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligoamenorrhoea and subfertility. Cochrane Database Syst Rev. 2012;5:CD003053–CD003053.
    1. Graham DJ, Green L, Senior JR, Nourjah P. Troglitazone-induced liver failure: a case study. Am J Med. 2003;114:299–306.
    1. Yki-Jarvinen H. Thiazolidinediones. N Engl J Med. 2004;351:1106–1118.
    1. Baillargeon JP, Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Nestler JE. Effects of metformin and rosiglitazone, alone and in combination, in nonobese women with polycystic ovary syndrome and normal indices of insulin sensitivity. Fertil Steril. 2004;82:893–902.
    1. Ortega-Gonzalez C, Luna S, Hernandez L, Crespo G, Aguayo P, Arteaga-Troncoso G, Parra A. Responses of serum androgen and insulin resistance to metformin and pioglitazone in obese, insulin-resistant women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1360–1365.
    1. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;6 CD007506.
    1. Birdsall TC, Kelly GS. Berberine: therapeutic potential of an alkaloid found in several medicinal plants. Altern Med Rev. 1997;2:94–103.
    1. Zhang Y, Li X, Zou D, Liu W, Yang J, Zhu N, Huo L, Wang M, Hong J, Wu P, Ren G, Ning G. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008;93:2559–2565.
    1. Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB. Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006;55:2256–2264.
    1. Xu MG, Wang JM, Chen L, Wang Y, Yang Z, Tao J. Berberine-induced upregulation of circulating endothelial progenitor cells is related to nitric oxide production in healthy subjects. Cardiology. 2009;112:279–286.
    1. Affuso F, Mercurio V, Ruvolo A, Pirozzi C, Micillo F, Carlomagno G, Grieco F, Fazio S. A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome. World J Cardiol. 2012;4:77–83.
    1. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;5:712–717.
    1. Mansfield R, Galea R, Brincat M, Hole D, Mason H. Metformin has direct effects on human ovarian steroidogenesis. Fertil Steril. 2003;97:956–962.
    1. Will MA, Palaniappan M, Peegel H, Kayampilly P, Menon KM. Metformin: direct inhibition of rat ovarian theca-interstitial cell proliferation. Fertil Steril. 2012;98:207–214.
    1. Wu X. Theca insulin resistance: dexamathasone induction and berberine intervention. Fertil Steril. 2010;94:s197.
    1. Zhao L, Li W, Han F, Hou L, Baillargeon JP, Kuang H, Wang Y, Wu X. Berberine reduces insulin resistance induced by dexamethasone in theca cells in vitro. Fertil Steril. 2011;95:461–463.
    1. Wu X, Yao J, Hou L, Kuang H. Berberine improves insulin resistance in granulosa cells in a similar way to metformin. Fertil Steril. 2006;86:459–460.
    1. Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012;166:99–105.
    1. Schulz KF, Altman DG, Moher D. CONSORT group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152:726–732.
    1. Zhao X, Ni R, Li L, Mo Y, Huang J, Huang M, Azziz R, Yang D. Defining hirsutism in Chinese women: a cross-sectional study. Fertil Steril. 2011;96:792–796.
    1. Cheng Q, Li Q, Bai X, Feng J, Huang J, Liu X. Establishment of botnia clamp technique in healthy women. J of Chongqing Med University. 2005;30:598–600.

Source: PubMed

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