Alterations of Gut Microbiome and Fecal Fatty Acids in Patients With Polycystic Ovary Syndrome in Central China Original paper

What was studied?

This study investigated alterations in the gut microbiome and fecal fatty acids in patients with polycystic ovary syndrome (PCOS), aiming to identify microbial signatures that may contribute to the pathophysiology of PCOS. In exploring this link, the authors evaluated gut microbiome structure using 16S rRNA sequencing and measured fecal short-chain fatty acids (SCFAs) through untargeted metabolomics. Because PCOS is increasingly associated with metabolic disturbances, the researchers investigated whether gut microbial shifts and elevated SCFAs—particularly acetic acid and propionic acid—could represent a microbiome signature relevant for metabolic dysfunction and hyperandrogenism in PCOS.

Who was studied?

The study analyzed 58 women from Central China, comprising 31 patients with PCOS and 27 healthy controls, all of whom were recruited prospectively under strict inclusion and exclusion criteria. Participants provided fecal samples for microbial and metabolite analyses and fasting blood samples for hormonal, inflammatory, and intestinal permeability assessment. PCOS participants were further stratified into BMI subgroups (≥24 kg/m² vs <24 kg m²), enabling exploration of microbiome differences related to body size within the pcos population.< p>

Most important findings

The study found no significant differences in α- or β-diversity, indicating similar overall microbial richness and community structure between groups. However, several specific taxa differed markedly. PCOS patients showed higher abundances of Klebsiella, Enterobacteriaceae, Gammaproteobacteria, Peptostreptococcaceae, and Bacteroidales S24-7 group, while healthy controls had higher levels of Ruminococcaceae UCG-013, Prevotellaceae UCG-001, and Erysipelatoclostridium. LEfSe analysis identified 14 PCOS-enriched genera and 4 control-enriched genera, demonstrating distinct microbial signatures despite unchanged global diversity. Notably, fecal acetic acid and propionic acid were significantly elevated in PCOS patients. Correlation analyses showed Megamonas positively associated with free testosterone, androstenedione, and insulin, while Alistipes negatively correlated with total testosterone. Alistipes and Eubacterium coprostanoligenes group were positively associated with multiple fatty acids, reflecting potentially altered fermentation pathways and SCFA overproduction. Markers of intestinal permeability and inflammation, including D-lactate, LBP, TNF-α, and DAO, were significantly elevated in PCOS, suggesting gut barrier dysfunction. BMI-stratified analyses revealed additional shifts, such as higher Abiotrophia and Peptostreptococcaceae in higher-BMI PCOS, reinforcing body-size-dependent microbial signatures.

Key implications

This study underscores that PCOS is associated with distinct microbial and metabolic signatures, particularly increases in potentially pro-inflammatory taxa and elevated SCFA fermentation products. These alterations may contribute to hyperandrogenism, insulin resistance, and intestinal permeability—all core components of PCOS pathophysiology. The findings reinforce the concept of a gut–endocrine axis, suggesting that microbial biomarkers could aid diagnostic refinement or stratification and that microbiome-targeted therapies—such as dietary modulation, probiotics, or fecal microbiota transplantation—warrant further clinical investigation for PCOS management.

Citation

Li G, Liu Z, Ren F, Shi H, Zhao Q, Song Y, Fan X, Ma X, Qin G. Alterations of gut microbiome and fecal fatty acids in patients with polycystic ovary syndrome in Central China. Front Microbiol. 2022;13:911992. doi:10.3389/fmicb.2022.911992