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Unexpected effects of treating insulin-resistant obese women with high-dose D-chiro-inositol: opening Pandora's box.

Frontiers in endocrinology
May 5, 2025
Sabrina Basciani et al. (4 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine whether high-dose D-chiro-inositol (DCI) combined with a hypocaloric Mediterranean diet improves metabolic and hormonal outcomes in overweight/obese women with insulin resistance.

Results Summary

The study found that DCI supplementation improved metabolic markers (insulin sensitivity, lipid profile, weight loss) but unexpectedly worsened hormonal profiles (increased hyperandrogenism and menstrual irregularity). The metabolic benefits were similar to diet alone, suggesting DCI's hormonal effects may complicate its use.

Population

48 insulin-resistant women aged 25-40 with a BMI of 26-32.

Effective Dosage

2400 mg/day of DCI.

Duration

4 months.

Interactions

None mentioned.

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
hypocaloric Mediterranean diet
increase
insulin sensitivity
women who were overweight/obese with insulin resistance
-
significant improvement
#1
hypocaloric Mediterranean diet
decrease
HOMA index
women who were overweight/obese with insulin resistance
-
reduction
#2
hypocaloric Mediterranean diet
decrease
blood glucose level
women who were overweight/obese with insulin resistance
-
reduction
#3
hypocaloric Mediterranean diet
decrease
fasting insulin level
women who were overweight/obese with insulin resistance
-
reduction
#4
hypocaloric Mediterranean diet
increase
lipid profile
women who were overweight/obese with insulin resistance
-
improvement
#5
hypocaloric Mediterranean diet
decrease
body weight
women who were overweight/obese with insulin resistance
-
significant decrease
#6
hypocaloric Mediterranean diet
decrease
BMI
women who were overweight/obese with insulin resistance
-
significant decrease
#7
high-dose D-chiro-inositol (DCI) treatment
increase
hyperandrogenism
women who were overweight/obese with insulin resistance
-
exhibiting
#8
high-dose D-chiro-inositol (DCI) treatment
increase
menstrual irregularity
women who were overweight/obese with insulin resistance
-
exhibiting
#9
high-dose D-chiro-inositol (DCI) treatment
increase
total testosterone
women who were overweight/obese with insulin resistance
-
significant increase
#10
high-dose D-chiro-inositol (DCI) treatment
increase
androstenedione
women who were overweight/obese with insulin resistance
-
significant increase
#11
high-dose D-chiro-inositol (DCI) treatment
increase
LH
women who were overweight/obese with insulin resistance
-
significant increase
#12
high-dose D-chiro-inositol (DCI) treatment
increase
menstrual length
women who were overweight/obese with insulin resistance
-
significant increase
#13
Abstract

PURPOSE: The combination of lifestyle changes and nutraceuticals, such as inositols, can reduce excess weight, leading to a reduction in insulin resistance and a normalization of the metabolic profile. As such, this study investigated the metabolic and hormonal changes observed in women who were overweight/obese with insulin resistance undergoing a hypocaloric Mediterranean diet combined with high-dose D-chiro-inositol (DCI) treatment. METHODS: In total, 48 insulin-resistant women between 25 and 40 years old, with a body mass index (BMI) between 26 and 32 were divided into two groups: both groups followed a hypocaloric Mediterranean diet for 4 months, and patients in the treated group also underwent treatment with 2400 mg/day of DCI for the same period. We evaluated the homeostasis model assessment (HOMA) index, body weight, BMI, blood glucose, fasting insulin, lipid profile [cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides] and hormonal profile [total testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and menstrual length] at baseline and at the end of treatment. RESULTS: After 4 months, both groups displayed a significant improvement in insulin sensitivity, as reflected by a reduction in the HOMA index, blood glucose level, fasting insulin level, and lipid profile. Furthermore, we observed a significant decrease in body weight and BMI in both groups. However, the evaluation of the hormonal profiles revealed unexpected findings, with the DCI-supplemented group exhibiting hyperandrogenism and menstrual irregularity, as demonstrated by the significant increase of total testosterone, androstenedione, LH, and menstrual length. CONCLUSION: The study strengthens the evidence regarding the metabolic benefits of the hypocaloric Mediterranean diet, independent from the association with DCI, on women with insulin resistance and excess weight, while also acknowledging the complex hormonal impact of high-dose DCI supplementation for medium-to-long periods.

Medical Subject Headings (MeSH)
HumansFemaleInsulin ResistanceAdultObesityInositolBody Mass IndexDiet, MediterraneanBlood Glucose
Study Links
Quality Scores
Safety50
Efficacy70/10
Quality80/10
Research Impact Scores
APT Score0.05
Weight Score2.60
Normalized Score0.64
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