Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women

Purpose Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alt...

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Published in:	Journal of endocrinological investigation Vol. 43; no. 6; pp. 779 - 786
Main Authors:	Schiuma, N., Costantino, A., Bartolotti, T., Dattilo, M., Bini, V., Aglietti, M. C., Renga, M., Favilli, A., Falorni, A., Gerli, S.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-06-2020 Springer Nature B.V
Subjects:	Adult Biomarkers - blood Blood Carbon Carbon cycle Carbon Cycle - physiology Cardiovascular diseases Drug therapy Endocrinology Fasting Fasting - blood Female Folic acid Follow-Up Studies Homocysteine Homocysteine - blood Humans Infertility Internal Medicine Medicine Medicine & Public Health Metabolic Diseases Micronutrients Micronutrients - administration & dosage Original Original Article Polycystic Ovary Syndrome - blood Polycystic Ovary Syndrome - diagnosis Polycystic Ovary Syndrome - diet therapy Prospective Studies Testosterone Young Adult Micronutrients One carbon cycle PCOS Homocysteine
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Summary:	Purpose Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. Methods This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland— n = 22) or no treatment ( n = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. Results The mean baseline fasting blood homocysteine was above the normal limit of 12 μMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. Conclusions In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1720-8386 0391-4097 1720-8386
DOI:	10.1007/s40618-019-01163-x