Supplementation with D-chiro-inositol in women

The world of natural compounds has been investigated with the aim of discovering possible medical applications ever since the origin of medicine. Recently, the field of gynecology has developed a growing interest regarding inositols. Inositols are cyclic polyols with a key role in many metabolic pathways. Their stability throughout the evolution of life can mark these molecules as prebiotic, due to their biochemical importance. These molecules can be classified into nine stereoisomeric compounds; among them, myo-inositol (MI) is the most important and frequent form found in nature. Inositols were first discovered in 1850 by Johanes Joseph Scherer and extracted from muscle cells, the name of which still persist in the compound (myo¼muscle in greek). In humans, inositols are derived from the diet in the primary form of MI. Subsequently, MI can be unidirectionally converted into different forms such as D-chiro-inositol (DCI), thanks to insulin action, and with the action of a specific nicotinamide adenine dinucleotide (NAD)-NADH-dependent epimerase. The primary focus of this chapter is to examine and discuss the biochemical properties of DCI and its clinical implication. In particular, it will provide the details of possible clinical applications of DCI supplementation in women, considering the principal biochemical effects.