Women who are diagnosed with PCOS are at increased risk for prediabetes.
Approximately 30 to 40 percent of women with PCOS have prediabetes, and 12.6 percent have type 2 diabetes. Up to 65 to 70 percent of women with PCOS are obese and often have insulin resistance, placing them at overt risk for diabetes.
In a small randomized, double-blind trial, women with PCOS who took resveratrol for 3 months had significantly lower total-testosterone (T) and dehydroepiandrosterone-sulfate (DHEAS) levels than women who took a placebo, senior author Antoni J Duleba, MD, and colleagues published in their report.
The findings suggest that resveratrol has “effects at both the ovarian and adrenal level,” without significant changes in body mass index (BMI), lipid profile, or markers of inflammation or endothelial function, they write.
Resveratrol is an antioxidant that occurs naturally in a variety of foods, including peanuts, pistachios, dark chocolate, blueberries, raspberries, and red grapes, and it is thought to contribute to the health benefits of red wine.
PCOS is the commonest endocrine disorder affecting women of reproductive age and is characterized by hyperplasia of ovarian theca cells, which produce androgens.
There is still no completely satisfactory way to manage the condition: use of antiandrogens and oral contraceptives (OCs) is often considered “clinically unacceptable” because they may cause liver damage and cannot be used in women considering pregnancy.
Dr. Duleba, professor and director, division of reproductive endocrinology and infertility, in the department of reproductive medicine, University of California, said in an interview that, in an effort to find a better treatment, the authors have been studying the effects of various antioxidants, including resveratrol, in ovarian cell cultures for several years. “We have shown that resveratrol and other antioxidants reduced growth of ovarian theca cells and reduced production of androgens,” most likely by inhibiting the expression of one of the enzymes involved in steroidogenesis.
They initially enrolled 34 women with PCOS. Each patient had at least two of these criteria: clinical or chemical hyperandrogenism; oligo- or amenorrhea; or polycystic ovaries as shown on transvaginal ultrasonography.
All of the women were recruited between December 2013 and March 2015. They were randomly assigned to take an oral supplement of micronized trans resveratrol at a dose of 1500 mg/day (RevGenetics) or a placebo for 3 months.
The mean age of the women in both groups was 26.8 years. Women in the resveratrol group had a mean total cholesterol of 200.1 mg/dL, compared with 169.1 mg/dL among women in the placebo group (P = .01).
The primary endpoint was change in total T. Patients and investigators were blinded as to each woman’s treatment group. The final analysis included 15 women in each group.
There was no significant decline in cholesterol levels in the resveratrol group; however, in the placebo group, cholesterol levels increased, so the authors speculate that resveratrol may have prevented an increase that would otherwise have occurred.
Women in the resveratrol group experienced a 23.1% decrease in mean serum total T, from 0.53 ng/mL at baseline to 0.41 ng/ml after 3 months of treatment (P = .01). Among women in the placebo group, total T was 0.48 ng/mL at baseline and 0.49 ng/mL after 3 months (P = .78).
Similarly, mean DHEAS went from 8.05 μmol/L at baseline among women taking resveratrol to 6.26 μmol/L after 3 months, a reduction of 22.2% (P = .01). Among women in the placebo group, mean DHEAS was 8.08 μmol/L at baseline and 8.90 μmol/L after 3 months (P = .08).
At baseline, mean fasting insulin among women in the resveratrol group was 14.5 μU/mL, compared with 9.8 μU/mL at 3 months, a 31.8% decrease (P = .007). In the placebo group, it remained unchanged, from a mean of 13.8 μU/mL at baseline to 13.8 μU/mL at 3 months (P = 1.00). The insulin-sensitivity index increased by 66.3%, from a mean of 3.11 at baseline to 5.12 after 3 months with resveratrol (P = .04), compared with 3.57 at baseline to 3.98 at 3 months in the placebo group (P = .45). Fasting glucose, however, did not change significantly in either group.
In a press release about the study, Dr. Duleba said that these findings “suggest resveratrol can improve the body’s ability to use insulin and potentially lower the risk of developing diabetes. The supplement may be able to help reduce the risk of metabolic problems common in women with PCOS.”
- Use of resveratrol was associated with a beneficial change in insulin metabolism.
- Women in the resveratrol group experienced a 23.1% decrease in mean serum total T, from 0.53 ng/mL at baseline to 0.41 ng/ml after 3 months of treatment.
- We will need more and larger studies on various doses of resveratrol before it can be recommended for routine clinical use.
J Clin Endocrinol Metab. Published online October 18, 2016. Article