Effect of alpha lipoic acid on polycystic ovary syndrome with insulin resistance

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women where insulin resistance plays an important role. Insulin resistance makes the first line treatment, clomiphene citrate (CC) treatment, become ineffective. Alpha Lipoic Acid (ALA) is believed to be an alternative treatment for CC-resistant PCOS. Objectives: The aim of the study is to understand the effect of ALA in Insuline receptor substrate 1 (IRS-1) expression, Glucosa transporter 4 (GLUT-4) expression, and folliculogenesis in insulin resistant PCOS rat model. Methods: This was an experimental study with randomized posttest only control group design. 30 females rat injected with testosterone propionate (TP) 1mg/100gram bodyweight for 28 days then divided into 3 groups. Negative control group receive no other treatment, positive control group receive a placebo for 14 days, and treatment group receive ALA for 14 days. IRS-1 and GLUT-4 expression is evaluated with immunohistochemistry, while folliculogenesis is evaluated by counting the number of follicle in each stage. Results: Mean IRS-1 expression in muscle in treatment group is significantly higher than other groups (4.28±1.05; 3.02±1.03; 1.86±0.83, p <0.01 respectively). Mean GLUT-4 expression in treatment group is significantly higher than other groups (4.28±0.91; 3.20±1.14; 1.40±0.55, p <0.01 respectively). Mean number of follicle in each stage in treatment group are significantly reduced than other groups (all p <0.05). Conclusion: ALA increase the expression of IRS-1 and GLUT-4, and also reduce the number of follicle in each stage of folliculogenesis.