Efficacy of probiotics combined with metformin and a calorie-restricted diet in obese patients with polycystic ovary syndrome

Abstract

Objective: To explore the efficacy of probiotics combined with metformin and a calorie-restricted diet in obese patients with polycystic ovary syndrome (PCOS).

Methods: Clinical data of 141 obese PCOS patients treated in the 73rd Group Army Hospital from June 2021 to December 2023 were retrospectively analyzed. Patients were grouped according to the treatment records: metformin group (n=69), patients treated with metformin and a calorie-restricted diet) and combined group (n=72, patients treated with probiotics combined with metformin and a calorie-restricted diet). Levels of endocrine hormone indicators, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Fasting blood glucose (FPG), gut microbiota status, and Body mass index (BMI) were compared before and after the treatment in two groups.

Results: After the treatment, the levels of endocrine hormone indicators, HOMA-IR, and FPG in both groups were significantly reduced compared to pre-treatment levels and were significantly lower in the combined group compared to the metformin group (P<0.05). Abundance of gut microbiota and Shannon Wiener diversity index in both groups significantly increased after the treatment and were markedly higher in the combined group than in the metformin group (P<0.05). Treatment led to a significant reduction in the body mass index (BMI) in all patients (P<0.05). However, post-treatment BMI was comparable in the two groups (P>0.05).

Conclusions: In obese patients with PCOS, adding probiotics to the metformin and calorie-restricted diet regimen is more effective in regulating hormone levels, improving blood sugar and insulin resistance, regulating gut microbiota status, and reducing BMI than metformin combined with calorie-restricted diet alone.

Keywords: Calorie restricted diet; Metformin; Obese patients; Polycystic ovary syndrome; Probiotics.

Fig.1

Comparison of endocrine hormone indicators between two groups. Estradiol (E2), testosterone (T), follicular stimulating hormone (FSH), and luteinizing hormone (LH); Compared with before treatment in the same group, ^aP<0.05; Compared with the metformin group after treatment, ^bP<0.05.

Fig.2

Comparison of HOMA-IR and FPG levels between two groups. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), fasting plasma glucose (FPG); Compared with before treatment in the same group, ^aP<0.05; Compared with the metformin group after treatment, ^bP<0.05.

Fig.3

Comparison of gut microbiota status between two groups. Compared with before treatment in the same group, ^aP<0.05; Compared with the metformin group after treatment, ^bP<0.05.

Fig.4

Comparison of BMI levels between two groups. Compared with before treatment in the same group, ^aP<0.05; Compared with the metformin group after treatment, ^bP<0.05.