Gut microbiota in adolescent girls with polycystic ovary syndrome: Effects of randomized treatments

Abstract

Summary Background Girls with obesity and polycystic ovary syndrome (PCOS) and women with PCOS have altered gut microbiota. Objective To study the gut microbiota composition of girls with PCOS without obesity (age, 15.8 years; body mass index [BMI] 25 kg/m2) and the effects of randomized treatments with an oral contraceptive (OC, N = 15) or with spironolactone‐pioglitazone‐metformin (SPIOMET, N = 15) for 1 year. Thirty‐one age‐matched girls served as controls. Methods 16S ribosomal subunit gene amplicon sequencing was performed in stool samples from all subjects; samples from 23 out of 30 girls with PCOS (OC, N = 12; SPIOMET, N = 11) were available for analysis post‐treatment. Clinical and endocrine‐metabolic variables were measured before and after intervention. Results Girls with PCOS had decreased diversity alpha, altered microbiota pattern and taxonomic profile with more abundance of Family XI (P = .002), and less abundance of family Prevotellaceae (P = .0006) the genus Prevotella (P = .0001) and Senegalimassilia (P < .0001), as compared to controls. Family XI abundance related positively to hepato‐visceral fat (R = 0.453; P = .0003). SPIOMET treatment, but not OC, normalized the abundance of Family XI. Prevotellaceae, Prevotella and Senegalimassilia abundance remained unchanged after either treatment. Conclusion SPIOMET's spectrum of normalizing effects in girls with PCOS is herewith broadened as to include Family XI abundance in gut microbiota.

Combined Oral Contraceptive Treatment Does Not Alter the Gut Microbiome but Affects Amino Acid Metabolism in Sera of Obese Girls With Polycystic Ovary Syndrome

“…A recent study contrasted changes in the gut microbiome in Catalonian adolescents with PCOS without obesity before and after treatment with OCP and combination of spironolactone, pioglitazone, and metformin (SPIOMET). ( Garcia-Beltran et al, 2021 ) No differences in α- or β-diversity were noted after treatment in the OCP group, the group receiving SPIOMET exhibited a reduction in the relative abundance of Family XI alongside reductions in hepato-visceral fat. It is possible that changes in the gut microbiome and downstream effects on host physiology may have occurred following SPIOMET, but not OCP use, because of direct actions on the microbiome.…”

Plant-derived tormentic acid alters the gut microbiota of the silkworm (Bombyx mori)

“…has been shown to decrease just after the metformin treatment. The relative abundance of Senegalimassilia spp has also been reported to be reduced in human polycystic ovarian syndrome cases 46 , and overweight children compared to the normal weight ones 47 . In conclusion, it can be said that TA, which is currently used in the treatment of type 2 diabetes, may have the potential to reverse the side effects of the widely used medication metformin.…”

“…has been shown to decrease just after the metformin treatment. The relative abundance of Senegalimassilia spp has also been reported to be reduced in human polycystic ovarian syndrome cases 46 , and overweight children compared to the normal weight ones 47 .…”

A narrative review of the role of gastrointestinal dysbiosis in the pathogenesis of polycystic ovary syndrome

“…We identified 14 human studies that compared the microbiota of patients diagnosed with PCOS with a variety of control groups [29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Ten of the 14 studies reported reduced alpha diversity in the PCOS group compared to the control populations [29][30][31][35][36][37][38][39][40]42].…”