The DOI matches its Crossref record; 36 of the 37 references it cites were found in a registry or an index.
Hyperinsulinemia Alters Myoinositol to d-chiroinositol Ratio in the Follicular Fluid of Patients With PCOS
Abstract
Myoinositol (MI) and d-chiroinositol (DCI) are 2 stereoisomers and insulin sensitizers. Their physiological ratio differs from tissue to tissue, and they are regulated by an insulin-dependent epimerase whose activity is drastically reduced in conditions of insulin resistance. Based on literature data and on the fact that MI phospholipids are follicle-stimulating hormone (FSH) second messengers, we speculated that patients with polycystic ovary syndrome (PCOS) having hyperinsulinemia, present an enhanced MI to DCI epimerization in the ovary, leading to MI deficiency that impairs FSH signaling, resulting in reduced oocyte quality. In the present study, 20 patients with PCOS and 20 healthy women were enrolled for measurement of MI and DCI levels in their follicular fluid. Follicular fluid samples were taken using a vaginal probe and both MI and DCI were quantified analytically. Results showed that the ratio of MI-DCI dropped from 100:1 in healthy participants to 0.2:1 in patients with PCOS who additionally displayed significantly higher levels of insulin resistance, hyperinsulinemia, and luteinizing hormone. This study is the first one to analyze the misbalance in the MI-DCI ratio in the ovary of patients with PCOS, supporting the concept that maintaining the physiological levels of the 2 stereoisomers is crucial, in restoring the ovarian functionality.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“In women without PCOS, the ovarian MI:DCI ratio is 100:1, but in women with PCOS, the ratio is 0.2:1 (13).”
From Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines (2024) · cites this paper as [13]
Citations
Cites
1 retracted
Papaleo, E., Unfer, V., Baillargeon, J.-P., Fusi, F., Occhi, F., & De Santis, L. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.01.088 · Cited by 197 · cited 2×
“MI-DCI ratio in the ovary, which might impair FSH signaling and worsen oocyte quality, as it has been shown by previously reported data.(24,35) Therefore, these new findings support the concept that a crucial factor for women with PCOS ovarian function is to maintain the physiological ovarian MI-DCI ratio.”
BackgroundResultRetracted(2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.004 · Cited by 9,050
The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group (2004) · Human Reproduction · doi:10.1093/humrep/deh098 · Cited by 6,138
Men at risk: occupation and male infertility.
Claman, P. (2004) · Fertility and Sterility · doi:10.1016/s0015-0282(03)01188-9 · Cited by 2,219
Nestler, J. E., Jakubowicz, D. J., Falcon de Vargas, A., Brik, C., Quintero, N., & Medina, F. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.6.4886 · Cited by 617
Ovulatory and Metabolic Effects of d-Chiro-Inositol in the Polycystic Ovary Syndrome
Nestler, J. E., Jakubowicz, D. J., Reamer, P., Gunn, R. D., & Allan, G. (1999) · New England Journal of Medicine · doi:10.1056/nejm199904293401703 · Cited by 518
Baillargeon, J.-P., Jakubowicz, D. J., Iuorno, M. J., Jakubowicz, S., & Nestler, J. E. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.02.127 · Cited by 300
D-Chiro-Inositol – Its Functional Role in Insulin Action and its Deficit in Insulin Resistance
Larner, J. (2002) · International Journal of Experimental Diabetes Research · doi:10.1080/15604280212528 · Cited by 279
Should all women with PCOS be treated for insulin resistance?
Marshall, J. C., & Dunaif, A. E. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.11.036 · Cited by 224
Rice, S., Christoforidis, N., Gadd, C., Nikolaou, D. S., Seyani, L., Donaldson, A., Margara, R. A., Hardy, K., & Franks, S. (2004) · Human Reproduction · doi:10.1093/humrep/deh609 · Cited by 224
Cited by
Sorted by citations
Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials
Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. E. (2017) · Endocrine Connections · doi:10.1530/ec-17-0243 · Cited by 220
Inositols in Insulin Signaling and Glucose Metabolism
Bevilacqua, A., & Bizzarri, M. (2018) · International Journal of Endocrinology · doi:10.1155/2018/1968450 · Cited by 192
Inositols: From Established Knowledge to Novel Approaches
Dinicola, S., Unfer, V., Facchinetti, F., Soulage, C. O., Greene, N. D., Bizzarri, M., Laganà, A. S., Chan, S.-Y., Bevilacqua, A., Pkhaladze, L., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms221910575 · Cited by 154
Self-citationEffects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials
Unfer, V., Nestler, J. E., Kamenov, Z. A., Prapas, N., & Facchinetti, F. (2016) · International Journal of Endocrinology · doi:10.1155/2016/1849162 · Cited by 151
Inositol in Polycystic Ovary Syndrome: Restoring Fertility through a Pathophysiology-Based Approach
Laganà, A. S., Garzon, S., Casarin, J., Franchi, M. P., & Ghezzi, F. (2018) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2018.09.001 · Cited by 178
Metadata
- Authors
- Unfer, V., Carlomagno, G., Papaleo, E., Vailati, S., Candiani, M., & Baillargeon, J.-P.
- Affiliations
- Agunco (IT)
- IRCCS Ospedale San Raffaele (IT)
- Université de Sherbrooke (CA)
- Corresponding author
- Carlomagno, Gianfranco
- Venue
- Reproductive Sciences
- Published
- 2014-07
- Volume
- 21
- Issue
- 7
- Pages
- 854-858
- ISSN
- 1933-7191 (ISSN-L)
- 1933-7205
- OpenAlex
- W2106706873
- Cited by
- 105
- References
- 37
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 8 · 2023: 16 · 2022: 10 · 2021: 11 · 2020: 11 · 2019: 8 · 2018: 9 · 2017: 7 · 2016: 11 · 2015: 4 · 2014: 2
- FWCI
- 9.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive Sciences (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- polycystic ovary syndrome, hyperinsulinemia, myo-inositol, follicular fluid, insulin resistance, epimerase, oocyte quality, luteinizing hormone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
