By Greg Arnold, DC, CSCS, September 4, 2014, abstracted from “Metabolic respons_e to folate supplementation in overweight women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial” in the July 2014 issue of Molecular Nutrition & Food Research

Polycystic ovary syndrome is a common hormonal disorder in women of reproductive age worldwide, affecting 5–10% (1). It is associated with menstrual disorders, fertility problems, polycystic ovaries, vascular endothelial dysfunction and high blood pressure (2,3). Insulin resistance is its main cause (4), making maintenance of normal insulin levels a high priority. A new study (5) showed that folic acid may help.

Eighty-one obese women weighing 65–110 kg, aged 18–40 and diagnosed with PCOS, received 1 mg folic acid, 5 mg folic acid or placebo daily for eight weeks. Blood samples were taken before and after.

After eight weeks, researchers noted several significant improvements in the folic acid groups compared with placebo:


Measure
Folic acid 1 mg daily: before/after, % change


Folic acid 5 mg daily


Before/after, % change
Placebo: before/after, % change

p-value

(probability level)
Homocysteine

14.6/12.9
11.7% decrease

17/14.8 


13% decrease
 19.5/20.5 
5.1% increase

0.009

Insulin
(micro Int.
Units milliliter)

10.0/9.6
4% decrease

12.1/10.4 

Decrease of
16.6%

12.0/14.6 

21.6% increase

0.006

HOMA-IR
(a method used to quantify insulin resistance and beta-cell function)

2.1/1.9 
9.6% decrease

2.4/2.1 
12.5% decrease

2.0/2.7 

35% increase

0.01

Total Cholesterol

(mg/dL)

160.1/156.1
2.5% decrease

166.6/138.8 

Decrease of
16.7% 

161.8/161.5

Decrease of
0.2% 

 0.01
LDL cholesterol (mg/dL)

88.4/85.4

Decrease of
3.4% 

100.4/70.7 

Decrease of
29.6% 

98.0/92.9 

Decrease of
5.3% 

0.007

Total-to-HDL

Cholesterol ratio

3.3/3.2 

Decrease of
3.1% 

3.8 /3.1
Decrease of
18.5%

3.8/ .9

Increase of
2.6%

0.01

Asked how folic acid produces these benefits, the researchers explained that it increases activation of AMP-activated protein kinase, an enzyme that improves insulin function (6). They concluded that “5 mg of folic acid daily for eight weeks in women with PCOS has beneficial effects on metabolic profiles.”

 

Reference:

1.     Costello, M.-F., Shrestha, B., Eden, J., Johnson, N.-P. et al., Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review. Hum. Reprod. 2007, 22, 1200– 1209.

2.     Brown, M.-A., Chang, R.-J., Polycystic ovary syndrome: clinical and imaging features. Ultrasound Q. 2007, 23, 233–238.

3.     Dumesic, D.-A., Abbott, D.-H., Padmanabhan, V., Polycystic ovary syndrome and its developmental origins. Rev. Endocr. Metab. Disord. 2007, 8, 127–141

4.     Yilmaz, M., Biri, A., Bukan, N., Karakoc, A. et al., Levels of lipoprotein and homocysteine in non-obese and obese patients with polycystic ovary syndrome. Gynecol. Endocrinol. 2005, 20, 258–263

5.     Asemi Z. Metabolic respons_e to folate supplementation in overweight women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial. Mol Nutr Food Res 2014 Jul;58(7):1465-73. doi: 10.1002/mnfr.201400033. Epub 2014 May 15

6.     Buettner, R., Bettermann, I., Hechtl, C., Gabele, E. et al., Dietary folic acid activates AMPK and improves insulin resistance and hepatic inflammation in dietary rodent models of the metabolic syndrome. Horm. Metab. Res. 2010; 42: 769–774

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