MELATONIN AS AN ADJUVANT THERAPY IN THE POLYCYSTIC OVARY SYNDROME: FOCUSING ON THE OVERWEIGHT/OBESE PHENOTYPE

SPINEDI E; SCAGLIA H; CARDINALI DP

Melatonin: Production, Functions and Benefits

Nova Science Publishers

Año: 2020;

The polycystic ovary syndrome (PCOS) is a highly frequent reproductive-endocrine disorder affecting up to 8-10% of women worldwide at the reproductive age. Although its etiology is not fully understood, evidence suggests that insulin resistance, with or without compensatory hyperinsulinemia, and clinical and/or biochemical hyperandrogenism are common features of the PCOS phenotypes. Dysfunctional white adipose tissue has been identified as a major contributing factor for insulin resistance. Overweight and/or obesity are very common in women with PCOS, thus suggesting that PCOS and Metabolic Syndrome (MS) female phenotypes share common characteristics. Environmental (e.g., chronodisruption) and genetic/epigenetic factors may also play relevant roles in syndrome development. Disturbance of the sleep/wake cycle has been reported to double in women with PCOS and obstructive sleep apnea is a common feature in PCOS patients. Several interrelated processes, such as circadian desynchronization, free radical-mediated damage, mitochondrial dysfunction and a low degree of inflammation have been identified as pathophysiological mechanisms in PCOS. In this context, melatonin, an unusual phylogenetically conserved compound present in all known aerobic phyla, has a promising significance as a cytoprotective molecule in addition to its chronobiotic properties. Androgen excess as well as genetic variants in melatonin receptor have been linked to increased risk of developing PCOS, to impairments in insulin secretion/action and to increased fasting glucose levels. Melatonin therapy protects against MS co-morbidities in PCOS and can be applied from the initial phases of patient?s treatment. This Chapter is focused on a revision of different PCOS phenotypes and, on the use of melatonin as a chronobiotic and cytoprotector in PCOS women with hyperandrogenism-related dysfunctional white adipose tissue mass.