Multimodal impact of myo- and D-chiro-inositol combined with glutathione and bioactive folate (Quatrefolic®) on the course of hyperandrogenic PCOS phenotypes

Authors

  • T.F. Tatarchuk SI «All-Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine»; SSI «Center of Innovative Medical Technologies of the NAS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-5498-4143
  • T.M. Tutchenko SI “All-Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0002-3003-3650
  • E.F. Chaikivska Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0000-0002-9150-1497
  • E.G. Christian O.O. Bogomolets National Medical University; Global Longevity Institute; Clinic Verum Expert, Kyiv, Ukraine https://orcid.org/0000-0003-0920-4627
  • R.O. Mnevets SI «All-Ukrainian Center of Motherhood and Childhood of the NAMS of Ukraine»; Educational and Scientific Centre «Institute of Biology and Medicine» of Taras Shevchenko National University of Kyiv, Kyiv, Ukraine https://orcid.org/0000-0001-9614-5762

DOI:

https://doi.org/10.18370/2309-4117.2025.81.66-76

Keywords:

polycystic ovary syndrome, sex hormone-binding globulin, metabolic dysfunction–associated steatotic liver disease, insulin resistance, hyperandrogenism

Abstract

Objective of the study: to evaluate the efficacy of a combination of myo-inositol (РњР†) and D-chiro-inositol (DCI) (in a 40:1 ratio) supplemented with glutathione and a bioactive form of folic acid (QuatrefolicВ®) on sex hormone-binding globulin (SHBG) levels, markers of hyperandrogenism, insulin resistance, and anthropometric parameters in women with hyperandrogenic polycystic ovary syndrome (PCOS) phenotypes and signs of metabolic dysfunction-associated steatotic liver disease.
Materials and methods. The study included 59 women of reproductive age with classical PCOS phenotypes and ultrasound evidence of hepatic steatosis. Patients were divided into two groups: the main group (n = 30) received a complex of MI + DCI (2000/50 mg) + glutathione (50 mg) + QuatrefolicВ® (400 Вµg) twice daily; the comparison group (n = 29) followed lifestyle modification recommendations only. Anthropometric data (body mass index and waist circumference, insulin resistance (HOMA-IR index), total testosterone, and SHBG were assessed, with the calculation of the free androgen index at baseline and after 4 months of intervention. Impact on ovulatory dysfunction was evaluated by luteinizing hormone dynamics and ultrasound evidence of ovulation.
Results. The main group receiving the comprehensive therapy demonstrated a statistically significant advantage over the lifestyle modification group. SHBG levels increased by 138% (from 26,35 В± 4,56 tРѕ 62,88 В± 11,54 nmol/L), leading to a radical 2,87-fold reduction in the free androgen index. Significant reductions in body mass index, waist circumference (3,88 cm vs. 1,52 cm in the comparison group), and normalization of the HOMA-IR index (2,18 В± 0,25) were observed, indicating effective management of insulin resistance and visceral obesity. Along with androgenic profile correction, gonadotropic function normalized: luteinizing hormone levels decreased 2,87-fold (from 19,8 В± 2,8 to 6,9 В± 1,9 U/L). The cumulative result of the therapy was the restoration of ovulatory cycles in 73.3% of patients (p < 0,001), confirming the efficacy of the multimodal impact on the hepato-ovarian axis in women with PCOS.
Conclusion. The addition of glutathione and QuatrefolicВ® to standard inositol therapy (in a 40:1 ratio) demonstrates a pronounced synergistic effect. This approach restores hepatic synthetic function, normalizes SHBG levels, and effectively corrects hormonal and metabolic disturbances in PCOS patients with concomitant hepatic steatosis, significantly outperforming standard lifestyle modification guidelines.

Author Biographies

T.F. Tatarchuk, SI «All-Ukrainian Center of Maternity and Childhood of the NAMS of Ukraine»; SSI «Center of Innovative Medical Technologies of the NAS of Ukraine», Kyiv

MD, professor, corresponding member of the National Academy of Medical Sciences of Ukraine;
deputy director for scientific work, head of the Department of Endocrine Gynecology;
chief researcher, Reproductive Health Department

T.M. Tutchenko, SI “All-Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”, Kyiv

PhD, senior researcher, Endocrine Gynecology Department;
Department of Reproductive Health

E.F. Chaikivska, Danylo Halytsky Lviv National Medical University, Lviv

MD, professor, Obstetrics, Gynaecology and Perinatology Department

E.G. Christian, O.O. Bogomolets National Medical University; Global Longevity Institute; Clinic Verum Expert, Kyiv

MD, professor, Department of Propedeutics of Internal Medicine;
CEO;
chief of Hepatology Department in clinic Verum Expert

R.O. Mnevets, SI «All-Ukrainian Center of Motherhood and Childhood of the NAMS of Ukraine»; Educational and Scientific Centre «Institute of Biology and Medicine» of Taras Shevchenko National University of Kyiv, Kyiv

postgraduate student, Department of Endocrine Gynecology;
assistant at the Department of Pediatrics, Obstetrics and Gynecology

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2025-12-30

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Tatarchuk, T., Tutchenko, T., Chaikivska, E., Christian, E., & Mnevets, R. (2025). Multimodal impact of myo- and D-chiro-inositol combined with glutathione and bioactive folate (Quatrefolic®) on the course of hyperandrogenic PCOS phenotypes. REPRODUCTIVE ENDOCRINOLOGY, (81), 66–76. https://doi.org/10.18370/2309-4117.2025.81.66-76

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No. 81 (2025)

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Interdisciplinary problems

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