Improved insulin sensitivity and reproductive profile in overweight/obese PCOS patients undergoing integrative treatment with carnitines, L-arginine, L-cysteine and myo-inositol

Gynecol Endocrinol. 2025 Dec;41(1):2458710. doi: 10.1080/09513590.2025.2458710. Epub 2025 Jan 28.

Abstract

Objective: To evaluate the effects of a combination of carnitines, L-arginine, L-cysteine and myo-inositol on metabolic and reproductive parameters in PCOS overweight/obese patients.

Methods: This was a retrospective study analyzing information of a group of PCOS (n = 25) overweight/obesity patients, not requiring hormonal treatment, selected from the database of the ambulatory clinic of the Gynecological Endocrinology Center at the University of Modena and Reggio Emilia, Modena, Italy. The hormonal profile, routine exams and insulin and C-peptide response to oral glucose tolerance test (OGTT) were evaluated before and after 12 weeks of a daily oral complementary treatment with L-carnitine (500 mg), acetyl-L-carnitine (250 mg), L-arginine (500 mg), L-cysteine (100 mg) and myo-inositol (1 gr). The hepatic insulin extraction index was also calculated.

Results: The mix of complementary substances significantly improved metabolic parameters, homeostatic model assessment for insulin resistance index values and gonadotropin plasma levels. Glucose, C-peptide and insulin response to OGTT was significantly reduced as well as the hepatic insulin extraction index.

Conclusion: The administration of a combination of carnitines, L-arginine, L-cysteine and myoinositol improved gonadotropin plasma levels and insulin sensitivity in overweight/obese PCOS patients and restored hepatic clearance of insulin as demonstrated by the decreased hepatic insulin extraction index.

Keywords: Carnitines; LH; PCOS; hepatic insulin extraction index; insulin resistance.

MeSH terms

  • Adult
  • Arginine* / administration & dosage
  • Arginine* / therapeutic use
  • Carnitine* / administration & dosage
  • Carnitine* / therapeutic use
  • Cysteine* / administration & dosage
  • Cysteine* / therapeutic use
  • Female
  • Glucose Tolerance Test
  • Humans
  • Inositol* / administration & dosage
  • Inositol* / therapeutic use
  • Insulin / blood
  • Insulin Resistance* / physiology
  • Obesity* / complications
  • Obesity* / drug therapy
  • Overweight* / complications
  • Overweight* / drug therapy
  • Polycystic Ovary Syndrome* / blood
  • Polycystic Ovary Syndrome* / complications
  • Polycystic Ovary Syndrome* / drug therapy
  • Polycystic Ovary Syndrome* / metabolism
  • Retrospective Studies
  • Young Adult

Substances

  • Inositol
  • Arginine
  • Cysteine
  • Carnitine
  • Insulin