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53,57,58 A meta-analysis of six randomized controlled trials with a total of 355 participants found myo-inositol was comparable to metformin with regard to its effects on fasting insulin and insulin sensitivity, testosterone, sex hormone binding globulin (SHBG), and body mass index (BMI) (a measure of body weight status) in women with PCOS, while metformin treatment carried a higher risk of adverse effects

One of these enzymes (glutathione synthetase) requires ATP in order to activate the production of reduced glutathione - this makes glutathione also dependent upon adequate ATP