Skip to main content
Top
Published in: Trials 1/2013

Open Access 01-12-2013 | Study protocol

Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial

Authors: Yan Li, Hongli Ma, Yuehui Zhang, Hongying Kuang, Ernest Hung Yu Ng, Lihui Hou, Xiaoke Wu

Published in: Trials | Issue 1/2013

Login to get access

Abstract

Background

Insulin resistance and hyperinsulinemia play a key role in the pathogenesis of polycystic ovary syndrome (PCOS), which is characterized by hyperandrogenism, ovulatory dysfunction, and presence of polycystic ovaries on pelvic scanning. Insulin resistance is significantly associated with the long-term risks of metabolic syndrome and cardiovascular disease. Berberine has effects on insulin resistance but its use in women with PCOS has not been fully investigated. In this paper, we present a research design evaluating the effects of berberine on insulin resistance in women with PCOS.

Methods/design

This is a multicenter, randomized, placebo-controlled and double-blind trial. A total of 120 patients will be enrolled in this study and will be randomized into two groups. Berberine or placebo will be taken orally for 12 weeks. The primary outcome is the whole body insulin action assessed with the hyperinsulinemic-euglycemic clamp.

Discussion

We postulate that women with PCOS will have improved insulin resistance following berberine administration.

Trial registration

This study is registered at ClinicalTrials.gov, NCT01138930.
Appendix
Available only for authorised users
Literature
1.
go back to reference Balen A: Pathogenesis of polycystic ovary syndrome–the enigma unravels?. Lancet. 1999, 354: 966-967.CrossRefPubMed Balen A: Pathogenesis of polycystic ovary syndrome–the enigma unravels?. Lancet. 1999, 354: 966-967.CrossRefPubMed
2.
go back to reference Diamanti-Kandarakis E, Papavassiliou AG: Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med. 2006, 12: 324-332.CrossRefPubMed Diamanti-Kandarakis E, Papavassiliou AG: Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med. 2006, 12: 324-332.CrossRefPubMed
3.
go back to reference Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH: Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligoamenorrhoea and subfertility. Cochrane Database Syst Rev. 2012, 5: CD003053-CD003053.PubMed Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH: Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligoamenorrhoea and subfertility. Cochrane Database Syst Rev. 2012, 5: CD003053-CD003053.PubMed
4.
go back to reference Graham DJ, Green L, Senior JR, Nourjah P: Troglitazone-induced liver failure: a case study. Am J Med. 2003, 114: 299-306.CrossRefPubMed Graham DJ, Green L, Senior JR, Nourjah P: Troglitazone-induced liver failure: a case study. Am J Med. 2003, 114: 299-306.CrossRefPubMed
6.
go back to reference Baillargeon JP, Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Nestler JE: Effects of metformin and rosiglitazone, alone and in combination, in nonobese women with polycystic ovary syndrome and normal indices of insulin sensitivity. Fertil Steril. 2004, 82: 893-902.CrossRefPubMed Baillargeon JP, Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Nestler JE: Effects of metformin and rosiglitazone, alone and in combination, in nonobese women with polycystic ovary syndrome and normal indices of insulin sensitivity. Fertil Steril. 2004, 82: 893-902.CrossRefPubMed
7.
go back to reference Ortega-Gonzalez C, Luna S, Hernandez L, Crespo G, Aguayo P, Arteaga-Troncoso G, Parra A: Responses of serum androgen and insulin resistance to metformin and pioglitazone in obese, insulin-resistant women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005, 90: 1360-1365.CrossRefPubMed Ortega-Gonzalez C, Luna S, Hernandez L, Crespo G, Aguayo P, Arteaga-Troncoso G, Parra A: Responses of serum androgen and insulin resistance to metformin and pioglitazone in obese, insulin-resistant women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005, 90: 1360-1365.CrossRefPubMed
8.
go back to reference Moran LJ, Hutchison SK, Norman RJ, Teede HJ: Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011, 6: CD007506 Moran LJ, Hutchison SK, Norman RJ, Teede HJ: Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011, 6: CD007506
9.
go back to reference Birdsall TC, Kelly GS: Berberine: therapeutic potential of an alkaloid found in several medicinal plants. Altern Med Rev. 1997, 2: 94-103. Birdsall TC, Kelly GS: Berberine: therapeutic potential of an alkaloid found in several medicinal plants. Altern Med Rev. 1997, 2: 94-103.
10.
go back to reference Zhang Y, Li X, Zou D, Liu W, Yang J, Zhu N, Huo L, Wang M, Hong J, Wu P, Ren G, Ning G: Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008, 93: 2559-2565.CrossRefPubMed Zhang Y, Li X, Zou D, Liu W, Yang J, Zhu N, Huo L, Wang M, Hong J, Wu P, Ren G, Ning G: Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008, 93: 2559-2565.CrossRefPubMed
11.
go back to reference Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB: Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006, 55: 2256-2264.CrossRefPubMed Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB: Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006, 55: 2256-2264.CrossRefPubMed
12.
go back to reference Xu MG, Wang JM, Chen L, Wang Y, Yang Z, Tao J: Berberine-induced upregulation of circulating endothelial progenitor cells is related to nitric oxide production in healthy subjects. Cardiology. 2009, 112: 279-286.CrossRefPubMed Xu MG, Wang JM, Chen L, Wang Y, Yang Z, Tao J: Berberine-induced upregulation of circulating endothelial progenitor cells is related to nitric oxide production in healthy subjects. Cardiology. 2009, 112: 279-286.CrossRefPubMed
13.
go back to reference Affuso F, Mercurio V, Ruvolo A, Pirozzi C, Micillo F, Carlomagno G, Grieco F, Fazio S: A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome. World J Cardiol. 2012, 4: 77-83.CrossRefPubMedPubMedCentral Affuso F, Mercurio V, Ruvolo A, Pirozzi C, Micillo F, Carlomagno G, Grieco F, Fazio S: A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome. World J Cardiol. 2012, 4: 77-83.CrossRefPubMedPubMedCentral
14.
go back to reference Yin J, Xing H, Ye J: Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008, 5: 712-717.CrossRef Yin J, Xing H, Ye J: Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008, 5: 712-717.CrossRef
15.
go back to reference Mansfield R, Galea R, Brincat M, Hole D, Mason H: Metformin has direct effects on human ovarian steroidogenesis. Fertil Steril. 2003, 97: 956-962.CrossRef Mansfield R, Galea R, Brincat M, Hole D, Mason H: Metformin has direct effects on human ovarian steroidogenesis. Fertil Steril. 2003, 97: 956-962.CrossRef
16.
go back to reference Will MA, Palaniappan M, Peegel H, Kayampilly P, Menon KM: Metformin: direct inhibition of rat ovarian theca-interstitial cell proliferation. Fertil Steril. 2012, 98: 207-214.CrossRefPubMedPubMedCentral Will MA, Palaniappan M, Peegel H, Kayampilly P, Menon KM: Metformin: direct inhibition of rat ovarian theca-interstitial cell proliferation. Fertil Steril. 2012, 98: 207-214.CrossRefPubMedPubMedCentral
17.
go back to reference Wu X: Theca insulin resistance: dexamathasone induction and berberine intervention. Fertil Steril. 2010, 94: s197-CrossRef Wu X: Theca insulin resistance: dexamathasone induction and berberine intervention. Fertil Steril. 2010, 94: s197-CrossRef
18.
go back to reference Zhao L, Li W, Han F, Hou L, Baillargeon JP, Kuang H, Wang Y, Wu X: Berberine reduces insulin resistance induced by dexamethasone in theca cells in vitro. Fertil Steril. 2011, 95: 461-463.CrossRefPubMed Zhao L, Li W, Han F, Hou L, Baillargeon JP, Kuang H, Wang Y, Wu X: Berberine reduces insulin resistance induced by dexamethasone in theca cells in vitro. Fertil Steril. 2011, 95: 461-463.CrossRefPubMed
19.
go back to reference Wu X, Yao J, Hou L, Kuang H: Berberine improves insulin resistance in granulosa cells in a similar way to metformin. Fertil Steril. 2006, 86: 459-460. Wu X, Yao J, Hou L, Kuang H: Berberine improves insulin resistance in granulosa cells in a similar way to metformin. Fertil Steril. 2006, 86: 459-460.
20.
go back to reference Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y: A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012, 166: 99-105.CrossRefPubMed Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y: A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012, 166: 99-105.CrossRefPubMed
21.
go back to reference Schulz KF, Altman DG, Moher D, CONSORT group: CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010, 152: 726-732.CrossRefPubMed Schulz KF, Altman DG, Moher D, CONSORT group: CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010, 152: 726-732.CrossRefPubMed
22.
go back to reference Zhao X, Ni R, Li L, Mo Y, Huang J, Huang M, Azziz R, Yang D: Defining hirsutism in Chinese women: a cross-sectional study. Fertil Steril. 2011, 96: 792-796.CrossRefPubMed Zhao X, Ni R, Li L, Mo Y, Huang J, Huang M, Azziz R, Yang D: Defining hirsutism in Chinese women: a cross-sectional study. Fertil Steril. 2011, 96: 792-796.CrossRefPubMed
23.
go back to reference Cheng Q, Li Q, Bai X, Feng J, Huang J, Liu X: Establishment of botnia clamp technique in healthy women. J of Chongqing Med University. 2005, 30: 598-600. Cheng Q, Li Q, Bai X, Feng J, Huang J, Liu X: Establishment of botnia clamp technique in healthy women. J of Chongqing Med University. 2005, 30: 598-600.
Metadata
Title
Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial
Authors
Yan Li
Hongli Ma
Yuehui Zhang
Hongying Kuang
Ernest Hung Yu Ng
Lihui Hou
Xiaoke Wu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Trials / Issue 1/2013
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-14-226

Other articles of this Issue 1/2013

Trials 1/2013 Go to the issue