Table 2.
Effect of supplementation on clinical and laboratory features in human subjects.
| Supplement | Dosage | Hormonal Changes | Changes in Lipid Profile | Changes in Oxidative Stress Markers | Genes Affected |
|---|---|---|---|---|---|
| Folate [22] | 5 mg/d for 8 weeks | ↓ Plasma Hcy, MDA, serum hs-CRP; ↑ plasma TAC and total GSH levels |
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| Omega-3 fatty acids and vitamin E [25] | Co-supplementation for 12 weeks |
↓ Serum TGA, VLDL, LDL- and total-/HDL cholesterol in PCOS subjects | ↑ Plasma TAC levels, ↓ malondialdehyde levels | Gene expression of Lp(a) and Ox-LDL | |
| Flaxseed oil omega-3 fatty acids [24] | Supplementation for 12 weeks |
↑ mFG scores | Beneficial effects on insulin metabolism, serum triglycerides, VLDL-cholesterol and hs-CRP levels | ||
| Fish oil omega-3 fatty acid [25] | Supplementation for 12 weeks | Beneficial effects on mental health parameters, total testosterone, hirsutism | Effective on insulin markers | ↓ Inflammatory markers and oxidative stress | |
| Vitamin E [26] | 100 mg/d | No significant differences of ovulation rate, clinical pregnancy rate and ongoing pregnancy rate | ↓ Oxidative stress | ||
| Alpha lipoic acid [27] | 600 mg twice daily for 16 weeks | No improvement in serum oxidative stress markers | |||
| Carnitine and chromium co-supplementation [28] | 1000 mg/d carnitine plus 200 mg/d chromium as chromium picolinate for 12 weeks | ↓ Total testosterone and hirsutism | ↓ Malondialdehyde (MDA) levels and higher total antioxidant capacity (TAC) | ↑ Gene expression of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-a) | |
| Melatonin supplementation [45] | 5 mg melatonin supplements | ↓ Hirsutism, serum total testosterone | ↓ Malondialdehyde (MDA) levels, ↑ plasma total antioxidant capacity (TAC) levels and total glutathione (GSH) |
↓ Gene expression of IL-1, (TNF-α) | |
| Curcumin supplementation [46] | 1500 mg/d Curcumin for 12 weeks | ↑ Serum activity of GPx | ↑ SIRT1 gene expression | ||
| Selenium supplementation [30] | 200 μg selenium per day for 8 weeks | ↑ Pregnancy rate, ↓ Alopecia and acne, ↓ Serum (DHEAS), hirsutism (modified Ferriman–Gallwey scores) |
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| Probiotic and selenium co- supplementation [32] | 8 × 109 CFU/d probiotic 200 μg/d |
↓Total testosterone, hirsutism | ↓ MDA levels, ↑ TAC and GSH levels |
||
| Selenium supplementation [29] | 200 mcg/d for 8 weeks | ↓ Serum triglycerides and VLDL-C concentrations | ↓ Serum insulin levels, homeostasis model of assessment-insulin resistance (HOMA-IR), (HOMA-B); ↑quantitative insulin sensitivity check index (QUICKI) |
||
| Soy isoflavones [34] | 50 mg/d soy isoflavones for 12 weeks | ↓ Circulating serum levels of insulin and HOMA-IR, ↑quantitative insulin sensitivity check index, ↓ free androgen index and serum triglycerides, ↑ plasma total glutathione,↓malondialdehyde |
↓ Free androgen index and serum triglycerides | ↓ Circulating serum levels of insulin and HOMA-IR, ↑ Quantitative insulin sensitivity check index, ↑ Plasma total glutathione ↓Malondialdehyde levels |
|
| Synbiotic supplementation [35] | Synbiotic supplements containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum | ↑ (SHBG), plasma NO, ↓ modified Ferriman–Gallwey (mFG) scores and serum hs-CRP |
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| Dietary soy [36] | 0.8 g protein kg−1 body weight (35% animal proteins, 35% soy protein and 30% vegetable proteins) | ↓ Total testosterone, ↓ triglycerides |
↓Triglycerides, body mass index (BMI), fasting plasma glucose, insulin and insulin resistance; ↑ quantitative insulin sensitivity check index | ↓ MDA, ↑ NO and GSH | |
| Probiotic supplementation [47] | Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum (2 × 109 CFU/g each) for 12 weeks | ↑ Serum SHBG and plasma TAC; ↓ serum total testosterone, mFG scores, serum hs-CRP and plasma MDA |
↑ Plasma TAC, ↓ plasma MDA |
||
| Vitamin D-K-calcium co-supplementation [38] | 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements for 8 weeks | ↓ Serum-free testosterone, ↓ luteinizing hormone |
↑ Plasma TAC, ↓ plasma MDA |
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| Vitamin D [48] | 4000 IU vitamin D or 1000 IU of vitamin D for 12 weeks | ↓ Total testosterone, free androgen index (FAI), hirsutism; ↑ mean change in SHBG |
↑ Total antioxidant capacity (TAC) | ||
| Vitamin D [49] | 50,000 IU Vitamin D | ↓ FPG, insulin, HOMA-IR, estimated B cell function; ↑ quantitative insulin sensitivity check index |
↓ Plasma malondialdehyde (MDA) levels | ||
| Vitamin D and [40] | 1000 IU vitamin D3 plus 1000 mg Vitamin E | ↓ Triglycerides, very low-density lipoprotein (VLDL) cholesterol levels | ↑ Serum 25(OH) D and plasma GSH, ↓ MDA |
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| Vitamin D and omega-3 co-supplementation [41] | 50,000 IU vitamin D every 2 weeks plus 2000 mg/d omega-3 fatty acid from fish oil | ↓ Serum total testosterone levels; ↑ Beck depression inventory, general health questionnaire scores and depression anxiety and stress scale scores | ↓ Serum hs-CRP and MDA, ↑ TAC compared with the placebo |
↓ Gene expression of (IL-1) and (VEGF) | |
| Vitamin D and probiotic co-supplementation [42] | 50,000 IU vitamin D and 8 × 109 CFU/d probiotic every 2 weeks | ↓ Total testosterone | ↓ MDA, ↑ TAC and GSH |
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| MitoQ10 and Vitamin D3 [43] | ↓ Estradiol, progesterone, FSH, LH, LH/FSH | ↓ MDA and SOD | ↓ mRNAs of 3β-HSD, Cyp19a1, Cyp11a1, StAR, Keap1, HO-1 and Nrf2 |
Abbreviations: FSH: follicle-stimulating hormone, LH: luteinizing hormone, MDA: malondialdehyde, SOD: superoxide dismutase, TAC: total antioxidant capacity, GSH: glutathione, (hs-CRP): high-sensitivity C-reactive protein, (25(OH) D): 25-hydroxyvitamin D, HOMA-IR: homeostasis model of assessment-IR, VLDL: very low-density lipoprotein, SHBG: sex hormone binding globulin, FAI: free androgen index, FPG: fasting plasma glucose, mFG: modified Ferriman–Gallway, TGA: triglycerides, NO: nitric oxide, Hcy: homocysteine. ↓ depressed, ↑ elevated.