The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome Original paper

What was studied?

This randomized, double-blind, placebo-controlled trial studied the effects of synbiotic supplementation on hormonal status, biomarkers of inflammation, and oxidative stress in women with polycystic ovary syndrome (PCOS). Specifically, the research aimed to evaluate the impact of synbiotics, comprising Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, and inulin, on clinical and biochemical markers in women with PCOS over 12 weeks. The primary focus was on assessing changes in hormone levels such as sex hormone-binding globulin (SHBG), free androgen index (FAI), modified Ferriman-Gallwey (mFG) score (for hirsutism), high-sensitivity C-reactive protein (hs-CRP), nitric oxide (NO) levels, and insulin resistance.

Who was studied?

The study involved 60 women diagnosed with PCOS according to the Rotterdam criteria. These women were randomly assigned to receive either synbiotics (n=30) or a placebo (n=30) for 12 weeks. The participants were screened for exclusion factors, including smoking, pregnancy, thyroid disorders, gastrointestinal problems, and the use of probiotics or synbiotics prior to the study. Clinical assessments and biochemical evaluations were performed before and after the intervention to measure the effects of synbiotic supplementation on the hormonal, inflammatory, and oxidative parameters of PCOS.

What were the most important findings?

The most significant findings of this study were that synbiotic supplementation led to notable improvements in several parameters associated with PCOS. Specifically, the synbiotic group showed a significant increase in SHBG and a decrease in the free androgen index (FAI), indicating a reduction in hyperandrogenism. There was also a significant reduction in mFG scores (indicating a reduction in hirsutism), and serum hs-CRP levels, which are associated with inflammation, were significantly reduced. Additionally, plasma NO levels were significantly increased in the synbiotic group, suggesting improved endothelial function. The synbiotic supplementation also resulted in a significant reduction in insulin levels and the HOMA-IR index, indicating improved insulin sensitivity. However, no significant changes were observed in other biomarkers of oxidative stress (such as total antioxidant capacity (TAC), glutathione (GSH), and malondialdehyde (MDA)).

From a microbiome perspective, the synbiotic intervention likely improved gut health and reduced inflammation, which is crucial in managing the systemic effects of PCOS. The improvement in metabolic and hormonal parameters suggests that synbiotics can restore balance in the gut microbiota, reduce systemic inflammation, and improve insulin resistance, all of which are key contributors to PCOS pathophysiology.

What are the greatest implications of this study?

The results of this study have significant clinical implications for the management of PCOS. The use of synbiotics as a treatment offers a promising non-pharmacological intervention for managing PCOS-related metabolic and hormonal disturbances. By improving insulin sensitivity, reducing inflammation, and balancing androgen levels, synbiotic supplementation may help alleviate symptoms like hirsutism and irregular menstruation. Moreover, this study supports the growing body of evidence linking gut microbiota modulation to endocrine health, suggesting that gut-targeted therapies could play a pivotal role in the treatment of PCOS. Clinically, synbiotics could serve as an adjunct to other PCOS treatments, offering a safer, more sustainable solution with fewer side effects compared to traditional medications. However, further studies with larger sample sizes and longer durations are needed to confirm these findings and establish long-term efficacy.