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Review
. 2024 Feb 1:15:1280983.
doi: 10.3389/fendo.2024.1280983. eCollection 2024.

Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization study

Junwei Sun  1   2 , Mingyu Wang  3 , Zhisheng Kan  1
Affiliations
Review

Causal relationship between gut microbiota and polycystic ovary syndrome: a literature review and Mendelian randomization study

Junwei Sun et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Numerous studies have suggested an association between gut microbiota and polycystic ovarian syndrome (PCOS). However, the causal relationship between these two factors remains unclear.

Methods: A review of observational studies was conducted to compare changes in gut microbiota between PCOS patients and controls. The analysis focused on four levels of classification, namely, phylum, family, genus, and species/genus subgroups. To further investigate the causal relationship, Mendelian randomization (MR) was employed using genome-wide association study (GWAS) data on gut microbiota from the MiBioGen consortium, as well as GWAS data from a large meta-analysis of PCOS. Additionally, a reverse MR was performed, and the results were verified through sensitivity analyses.

Results: The present review included 18 observational studies that met the inclusion and exclusion criteria. The abundance of 64 gut microbiota taxa significantly differed between PCOS patients and controls. Using the MR method, eight bacteria were identified as causally associated with PCOS. The protective effects of the genus Sellimonas on PCOS remained significant after applying Bonferroni correction. No significant heterogeneity or horizontal pleiotropy was found in the instrumental variables (IVs). Reverse MR analyses did not reveal a significant causal effect of PCOS on gut microbiota.

Conclusion: The differences in gut microbiota between PCOS patients and controls vary across observational studies. However, MR analyses identified specific gut microbiota taxa that are causally related to PCOS. Future studies should investigate the gut microbiota that showed significant results in the MR analyses, as well as the underlying mechanisms of this causal relationship and its potential clinical significance.

Keywords: Mendelian randomization; causation; gut microbiota; polycystic ovarian syndrome; review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
MR basic assumptions and overview of MR analyses process. The red X cross means that the IVs (instrumental variables) cannot influence the outcome throuth this path.
Figure 2
Figure 2
Flowchart of the literature selection.
Figure 3
Figure 3
The results of MR analysis on the causal effect of the eight gut microbiota taxa on PCOS.
Figure 4
Figure 4
Scatter plots for the causal association between gut microbiota and PCOS.
Figure 5
Figure 5
Leave-one-out plots for the causal association between gut microbiota and PCOS.
See this image and copyright information in PMC

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