Inositols in the Treatment of Insulin-Mediated Diseases

Giovanna Muscogiuri, Stefano Palomba, Antonio Simone Laganà, Francesco Orio, Giovanna Muscogiuri, Stefano Palomba, Antonio Simone Laganà, Francesco Orio

Abstract

A growing body of research is currently focused on the role of inositol isomers and in particular myo-inositol (MYO-INS) and D-chiroinositol (DCI) in the treatment of insulin resistance states. Both isomers have been shown to exert insulin-mimetic action and to lower postprandial glucose. Further, insulin resistance-related diseases were associated to derangements in inositol metabolism. Thus, the aim of this review is to provide current evidence on the potential benefits of inositol isomers (MYO-INS and DCI) in the treatment of disease associated to insulin resistance such as polycystic ovary syndrome (PCOS), gestational diabetes, and metabolic syndrome. Finally, molecular insights into inositol insulin-sensitizing effects will be covered focusing on the possible role of inositol glycans as insulin second messengers.

References

    1. Nestler J. E., Jakubowicz D. J., Reamer P., Gunn R. D., Allan G. Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. The New England Journal of Medicine. 1999;340(17):1314–1320. doi: 10.1056/nejm199904293401703.
    1. Unfer V., Carlomagno G., Dante G., Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecological Endocrinology. 2012;28(7):509–515. doi: 10.3109/09513590.2011.650660.
    1. Heimark D., McAllister J., Larner J. Decreased myo-inositol to chiro-inositol (M/C) ratios and increased M/C epimerase activity in PCOS theca cells demonstrate increased insulin sensitivity compared to controls. Endocrine Journal. 2014;61(2):111–117. doi: 10.1507/endocrj.EJ13-0423.
    1. Di Paolo G., De Camilli P. Phosphoinositides in cell regulation and membrane dynamics. Nature. 2006;443(7112):651–657. doi: 10.1038/nature05185.
    1. Genazzani A. D., Santagni S., Ricchieri F., et al. Myo-inositol modulates insulin and luteinizing hormone secretion in normal weight patients with polycystic ovary syndrome. Journal of Obstetrics and Gynaecology Research. 2014;40(5):1353–1360. doi: 10.1111/jog.12319.
    1. Downes C. P., Macphee C. H. Myo-Inositol metabolites as cellular signals. European Journal of Biochemistry. 1990;193(1):1–18. doi: 10.1111/j.1432-1033.1990.tb19297.x.
    1. Strange K., Morrison R., Heilig C. W., DiPietro S., Gullans S. R. Upregulation of inositol transport mediates inositol accumulation in hyperosmolar brain cells. American Journal of Physiology—Cell Physiology. 1991;260(4, part 1):C784–C790.
    1. Sun T.-H., Heimark D. B., Nguygen T., Nadler J. L., Larner J. Both myo-inositol to chiro-inositol epimerase activities and chiro-inositol to myo-inositol ratios are decreased in tissues of GK type 2 diabetic rats compared to Wistar controls. Biochemical and Biophysical Research Communications. 2002;293(3):1092–1098. doi: 10.1016/S0006-291X(02)00313-3.
    1. Larner J. D-chiro-inositol—its functional role in insulin action and its deficit in insulin resistance. International Journal of Experimental Diabetes Research. 2002;3(1):47–60. doi: 10.1080/15604280212528.
    1. Larner J., Craig J. W. Urinary myo-inositol-to-chiro-inositol ratios and insulin resistance. Diabetes Care. 1996;19(1):76–78. doi: 10.2337/diacare.19.1.76.
    1. Kennington A. S., Hill C. R., Craig J., et al. Low urinary chiro-inositol excretion in non-insulin-dependent diabetes mellitus. The New England Journal of Medicine. 1990;323(6):373–378. doi: 10.1056/nejm199008093230603.
    1. Asplin I., Galasko G., Larner J. chiro-Inositol deficiency and insulin resistance: a comparison of the chiro-inositol- and the myo-inositol-containing insulin mediators isolated from urine, hemodialysate, and muscle of control and type II diabetic subjects. Proceedings of the National Academy of Sciences of the United States of America. 1993;90(13):5924–5928. doi: 10.1073/pnas.90.13.5924.
    1. Ehrmann D. A. Polycystic ovary syndrome. The New England Journal of Medicine. 2005;352(12):1223–1236. doi: 10.1056/nejmra041536.
    1. Orio F., Palomba S. Reproductive endocrinology: new guidelines for the diagnosis and treatment of PCOS. Nature Reviews Endocrinology. 2014;10(3):130–132. doi: 10.1038/nrendo.2013.248.
    1. Orio F., Palomba S., Colao A. Cardiovascular risk in women with polycystic ovary syndrome. Fertility and Sterility. 2006;86(1):S20–S21. doi: 10.1016/j.fertnstert.2006.03.003.
    1. Orio F., Jr., Palomba S., Spinelli L., et al. The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study. Journal of Clinical Endocrinology and Metabolism. 2004;89(8):3696–3701. doi: 10.1210/jc.2003-032049.
    1. Genazzani A. D., Lanzoni C., Ricchieri F., Jasonni V. M. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecological Endocrinology. 2008;24(3):139–144. doi: 10.1080/09513590801893232.
    1. Genazzani A. D., Prati A., Santagni S., et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecological Endocrinology. 2012;28(12):969–973. doi: 10.3109/09513590.2012.685205.
    1. Gerli S., Papaleo E., Ferrari A., di Renzo G. C. Randomized, double blind placebo-controlled trial: effects of Myo-inositol on ovarian function and metabolic factors in women with PCOS. European Review for Medical and Pharmacological Sciences. 2007;11(5):347–354.
    1. Artini P. G., Di Berardino O. M., Papini F., et al. Endocrine and clinical effects of Myo-Inositol administration in polycystic ovary syndrome. A randomized study. Gynecological Endocrinology. 2013;29(4):375–379. doi: 10.3109/09513590.2012.743020.
    1. Iuorno M. J., Jakubowicz D. J., Baillargeon J.-P., et al. Effects of D-chiro-inositol in lean women with the polycystic ovary syndrome. Endocrine Practice. 2002;8(6):417–423. doi: 10.4158/ep.8.6.417.
    1. Laganà A. S., Barbaro L., Pizzo A. Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with D-Chiro-Inositol. Archives of Gynecology and Obstetrics. 2015;291(5):1181–1186. doi: 10.1007/s00404-014-3552-6.
    1. Giordano D., Corrado F., Santamaria A., et al. Effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome: a perspective, randomized, placebo-controlled study. Menopause. 2011;18(1):102–104. doi: 10.1097/gme.0b013e3181e8e1b1.
    1. Santamaria A., Giordano D., Corrado F., et al. One-year effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome. Climacteric. 2012;15(5):490–495. doi: 10.3109/13697137.2011.631063.
    1. Corrado F., D'Anna R., Di Vieste G., et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabetic Medicine. 2011;28(8):972–975. doi: 10.1111/j.1464-5491.2011.03284.x.
    1. D'Anna R., Scilipoti A., Giordano D., et al. Myo-inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: A Prospective, Randomized, Placebo-Controlled Study. Diabetes Care. 2013;36(4):854–857. doi: 10.2337/dc12-1371.
    1. Diamanti-Kandarakis E., Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine Reviews. 2012;33(6):981–1030. doi: 10.1210/er.2011-1034.
    1. Stepto N. K., Cassar S., Joham A. E., et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Human Reproduction. 2013;28(3):777–784. doi: 10.1093/humrep/des463.
    1. Harrison C. L., Stepto N. K., Hutchison S. K., Teede H. J. The impact of intensified exercise training on insulin resistance and fitness in overweight and obese women with and without polycystic ovary syndrome. Clinical Endocrinology. 2012;76(3):351–357. doi: 10.1111/j.1365-2265.2011.04160.x.
    1. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews. 1997;18(6):774–800. doi: 10.1210/er.18.6.774.
    1. Skov V., Glintborg D., Knudsen S., et al. Reduced expression of nuclear-encoded genes involved in mitochondrial oxidative metabolism in skeletal muscle of insulin-resistant women with polycystic ovary syndrome. Diabetes. 2007;56(9):2349–2355. doi: 10.2337/db07-0275.
    1. Zhang H. Y., Guo C. X., Zhu F. F., Qu P. P., Lin W. J., Xiong J. Clinical characteristics, metabolic features, and phenotype of Chinese women with polycystic ovary syndrome: a large-scale case-control study. Archives of Gynecology and Obstetrics. 2013;287(3):525–531. doi: 10.1007/s00404-012-2568-z.
    1. Detti L., Jeffries-Boyd H. E., Williams L. J., Diamond M. P., Uhlmann R. A. Fertility biomarkers to estimate metabolic risks in women with polycystic ovary syndrome. Journal of Assisted Reproduction and Genetics. 2015;32(12):1749–1756. doi: 10.1007/s10815-015-0602-3.
    1. Bozdag G., Yildiz B. O. Combined oral contraceptives in polycystic ovary syndrome—indications and cautions. Frontiers of Hormone Research. 2013;40:115–127. doi: 10.1159/000341823.
    1. Legro R. S., Arslanian S. A., Ehrmann D. A., et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2013;98(12):4565–4592. doi: 10.1210/jc.2013-2350.
    1. De Leo V., La Marca A., Petraglia F. Insulin-lowering agents in the management of polycystic ovary syndrome. Endocrine Reviews. 2003;24(5):633–667. doi: 10.1210/er.2002-0015.
    1. Dunn C. J., Peters D. H. Metformin. A review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus. Drugs. 1995;49(5):721–749. doi: 10.2165/00003495-199549050-00007.
    1. Jiralerspong S., Palla S. L., Giordano S. H., et al. Metformin and pathologic complete responses to neoadjuvant chemotherapy in diabetic patients with breast cancer. Journal of Clinical Oncology. 2009;27(20):3297–3302. doi: 10.1200/jco.2009.19.6410.
    1. He X.-X., Tu S. M., Lee M.-H., Yeung S.-C. J. Thiazolidinediones and metformin associated with improved survival of diabetic prostate cancer patients. Annals of Oncology. 2011;22(12):2640–2645. doi: 10.1093/annonc/mdr020.mdr020
    1. Luo Z., Zang M., Guo W. AMPK as a metabolic tumor suppressor: control of metabolism and cell growth. Future Oncology. 2010;6(3):457–470. doi: 10.2217/fon.09.174.
    1. Liu G., Song Y., Cui L., Wen Z., Lu X. Inositol hexaphosphate suppresses growth and induces apoptosis in HT-29 colorectal cancer cells in culture: PI3K/Akt pathway as a potential target. International Journal of Clinical and Experimental Pathology. 2015;8(2):1402–1410.
    1. Singh R. P., Agarwal R. Prostate cancer and inositol hexaphosphate: efficacy and mechanisms. Anticancer Research. 2005;25(4):2891–2903.
    1. Minozzi M., D'Andrea G., Unfer V. Treatment of hirsutism with Myo-Inositol: a prospective clinical study. Reproductive BioMedicine Online. 2008;17(4):579–582. doi: 10.1016/s1472-6483(10)60248-9.
    1. Croze M. L., Soulage C. O. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie. 2013;95(10):1811–1827. doi: 10.1016/j.biochi.2013.05.011.
    1. Papaleo E., Unfer V., Baillargeon J.-P., et al. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecological Endocrinology. 2007;23(12):700–703. doi: 10.1080/09513590701672405.
    1. La Marca A., Grisendi V., Dondi G., Sighinolfi G., Cianci A. The menstrual cycle regularization following D-chiro-inositol treatment in PCOS women: a retrospective study. Gynecological Endocrinology. 2015;31(1):52–56. doi: 10.3109/09513590.2014.964201.
    1. Pizzo A., Laganà A. S., Barbaro L. Comparison between effects of myo-inositol and d-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecological Endocrinology. 2014;30(3):205–208. doi: 10.3109/09513590.2013.860120.
    1. Facchinetti F., Bizzarri M., Benvenga S., et al. Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in obstetrics and gynecology: the link between metabolic syndrome and PCOS. European Journal of Obstetrics Gynecology and Reproductive Biology. 2015;195:72–76. doi: 10.1016/j.ejogrb.2015.09.024.
    1. Shen H., Shao M., Cho K. W., et al. Herbal constituent sequoyitol improves hyperglycemia and glucose intolerance by targeting hepatocytes, adipocytes, and β-cells. American Journal of Physiology—Endocrinology and Metabolism. 2012;302(8):E932–E940. doi: 10.1152/ajpendo.00479.2011.
    1. Dang N. T., Mukai R., Yoshida K.-I., Ashida H. D-pinitol and myo-inositol stimulate translocation of glucose transporter 4 in skeletal muscle of C57BL/6 mice. Bioscience, Biotechnology and Biochemistry. 2010;74(5):1062–1067. doi: 10.1271/bbb.90963.
    1. Croze M. L., Vella R. E., Pillon N. J., et al. Chronic treatment with myo-inositol reduces white adipose tissue accretion and improves insulin sensitivity in female mice. Journal of Nutritional Biochemistry. 2013;24(2):457–466. doi: 10.1016/j.jnutbio.2012.01.008.

Source: PubMed

Подписаться