Insulin-stimulated release Of D-chiro-inositol-containing inositolphosphoglycan mediator correlates with insulin sensitivity in women with polycystic ovary syndrome

Some actions Of insulin are mediated by inositolphosphoglycan (IPG) mediators. Deficient release of a Putative D-chiro-inositol-containing (DCI) IPG mediator may contribute to insulin resistance in women with polycystic ovary syndrome (PCOS). Previously, we demonstrated that oral DC] Supplementation improved ovulation and metabolic parameters in women with PCOS. However, whether oral DCI mediates in increase in the release of the DCI-IPG mediator and an improvement in insulin sensitivity in women with PCOS is unknown. We conducted a randomized controlled trial of DCI supplementation vs placebo in I I women with PCOS who were assessed at 2 time points 6 weeks apart. Plasma DCI, DCI-IPG release during oral glucose tolerance test (AUC(DCI-IPG)), and insulin sensitivity (S-i) by frequently sampled intravenous glucose tolerance test were assessed at baseline and end of study. The study was terminated early because of a sudden Unavailability of the study drug. However. ill all Subjects without regard to treatment assignment, there was a positive correlation the 6-week period (r = 0.69 P =.02). which remained between the change in AUC(DCI-1PG)/AUC(insulin) ratio and the change in S-i during the 6 significant after adjustment for body mass index (P = 0.22) and after further adjustment for body mass index and treartment allocation (P = .0261). This suggests that, in women with PCOS, increased glucose-stimulated DCI-IPG release is significantly correlated with improved insulin for therapeutic interventions in PCOS. (C) 2008 Elsevier Inc. All rights reserved.