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.

中文翻译：

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微量营养素支持PCOS妇女中一个禁食碳半胱氨酸的碳循环调节。

目的空腹血液中的高半胱氨酸在PCOS妇女中增加，并且参与多种并发症，包括心血管疾病和不育症。基于超生理剂量叶酸管理的矫正干预作用很小。我们旨在测试一种替代方法。方法这是一项前瞻性，随机，平行组，开放标签，对照或无治疗的临床研究。将年龄≥18岁，无系统性疾病和药物治疗的PCOS妇女以2：1的比例随机分配，以支持碳循环的活化微量营养素（Impryl，Parthenogen，瑞士-n = 22）或不进行治疗（n = 10），并随访3个月。空腹血同型半胱氨酸，AMH，睾丸激素，SHBGs和所得的FTI在随访之前和结束时进行了测试。结果平均基线空腹血同型半胱氨酸高于正常水平12μMol/ L，与SHBG呈负相关。AMH也升高，而睾丸激素，SHBG和FTI均在正常范围内。该处理实现了高半胱氨酸的显着降低，而对照组中的高半胱氨酸没有改变，与起始值无关。该治疗还仅在基线时具有同型半胱氨酸正常的亚组中引起AMH升高和SHBG降低。结论在PCOS女士中，血液中的高半胱氨酸水平升高，与SHBG呈负相关。在所有暴露的患者中，支持碳循环的活化微量营养素的生理量实际上都减少了。这是否具有临床益处还有待确定。