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. 2024 Nov 22;17(1):232.
doi: 10.1186/s13048-024-01550-w.

Gut microbiota and gut-derived metabolites are altered and associated with dietary intake in women with polycystic ovary syndrome

Thaís Rasia da Silva  1   2 , Lucas Bandeira Marchesan  1   2 , Pabulo Henrique Rampelotto  3   4 , Larisse Longo  4   5 , Tiago Franco de Oliveira  6 , Rikard Landberg  7 , Vanessa de Mello  8 , Poli Mara Spritzer  9   10   11   12
Affiliations

Gut microbiota and gut-derived metabolites are altered and associated with dietary intake in women with polycystic ovary syndrome

Thaís Rasia da Silva et al. J Ovarian Res. .

Abstract

Background: Disturbances in the gut microbiota may act as mechanisms influencing the interplay between dietary factors and metabolic disorders. Studies have demonstrated that these alterations are associated with the diagnosis of polycystic ovary syndrome (PCOS). Within this context, we aimed to investigate associations between gut microbiota, gut-derived metabolites (short-chain fatty acids [SCFAs] and indole-3-propionic acid [IPA]), and dietary intake in women with PCOS.

Methods: We conducted a cross-sectional study of 24 women with PCOS, previously recruited for two studies at our research center, compared with 14 age-matched healthy controls. The mean (SD) age of all 38 participants was 33.3 (7.5) years, and the mean (SD) body mass index was 29.5 (4.8) kg/m2. Primary outcomes included gut microbiota analysis by sequencing the V4 region of the 16 S rRNA gene, serum IPA levels measured by liquid chromatography/triple-quadrupole mass spectrometry (LC-QqQ-MS), and fecal and plasma SCFA levels measured by LC-MS/MS.

Results: Gut microbiota diversity, composition, and metabolic pathways differed between the PCOS and control groups. A higher abundance of two operational taxonomic units specializing in complex carbohydrate metabolism was observed in healthy control women. The PCOS group exhibited a less favorable dietary intake than the control group, and a significant correlation was observed between gut microbiota composition and dietary glycemic load in PCOS (r = 0.314, P = 0.03 in Mantel test). Multivariable-adjusted linear regression models indicated that lower levels of IPA and higher circulating levels of two SCFAs (acetic acid and propionic acid) were independently associated with the diagnosis of PCOS.

Conclusions: Our data support the differentiation between women with PCOS and healthy controls based on gut microbiota analysis. Furthermore, changes in gut bacteria and their metabolites could be, at least in part, the biological mechanism by which a low glycemic load diet may potentially improve PCOS-related reproductive and cardiometabolic outcomes.

Keywords: Diet; Gut microbiome; Indole-3-propionic acid; Polycystic ovary syndrome; Short-chain fatty acids.

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Conflict of interest statement

Declarations. Consent for publication: Consent forms are available from the corresponding author on request. Competing interests: The authors declare no competing interests. Human Ethics and Consent to Participate: Each study participant provided written informed consent before enrollment. The study was approved by the HCPA Ethics Committee (CAAE 35025414.1.0000.5327) and conducted in accordance with the Helsinki Declaration. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
(A) Alpha diversity analysis: women with PCOS (n = 21) vs. healthy controls (n = 10); statistical confidence for the sample grouping was assessed using permutational multivariate analysis of variance (PERMANOVA); Observed (P = 0.04), ACE (P = 0.03), Simpson (P = 0.04), and Shannon (P = 0.06). (B) Principal coordinate analysis (PCoA) of bacterial communities based on Bray-Curtis distance, comparison between women with PCOS (n = 21) and healthy controls (n = 10) (P = 0.04 by analysis of similarities, ANOSIM)
Fig. 2
Fig. 2
Relative abundance of the 10 most abundant (A) phyla, (B) families, and (C) genera in women with PCOS (n = 21) and healthy controls (n = 10)
Fig. 3
Fig. 3
Linear discriminant analysis (LDA) effect size (LEfSe) at the OTU level between women with PCOS (n = 21) and healthy controls (n = 10). Statistical confidence was assessed using the Kruskal-Wallis test. Taxa were ranked by the LDA score, where a logarithmic LDA score threshold of ± 1.5 indicated significant differences at P < 0.05
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