Clinical Trial On The Correlation Between Intestinal Flora And Inflammation In Obese PCOS

ObjectivePolycystic ovarian syndrome(PCOS)is one of the common endocrine diseases in gynecology for reproductive-aged women,its patients’ life is affected seriously with the long-term complications,including type 2 diabetes,metabolic syndrome,and cardiovascular disease.Chronic inflammation may accelerate the long-term complications in PCOS,especially for obese PCOS patients.Several studies have shown that the intestinal flora is closely related to chronic inflammation in obesity and metabolic syndrome.As for PCOS patients,it has been shown that the gut microbiome is disrupted,which has a tight correlation with their metabolism and sex hormone.However,there are few clinical studies committed to the relationship between gut microbiota and chronic inflammation in PCOS.A diet based on whole-grains,traditional Chinese medicinal foods and prebiotics(WTP),which perhaps via an inflammation-mediated pathway to manipulate the intestinal flora,has been shown it meaningful to improve the chronic inflammatory state of patients with obesity and metabolic syndrome.We previous study has confirmed that WTP diet intervention can adjust the intestinal flora and improve their metabolism in obese PCOS patients.But whether it can improve the inflammation in obese PCOS patients is not yet known.Therefore,we currently investigate the correlation between the intestinal flora and chronic inflammation in obese PCOS patients via a WTP diet,devoting to monitoring PCOS progression,preventing long-term complications,improving the quality of life for patients,and seeking a new way to better manage PCOS.MethodsPatients diagnosed as PCOS were recruited from Zhengzhou University People’s Hospital between May 2018 and July 2019,then were carried on a WTP diet for three months.Everyone was claimed to return monthly,in order to record their weight,hirsutism,acne and menstruation.Otherwise,their blood lipids,glucose,and insulin concentration were detected simultaneously.Moreover,we measured their serum C-reactive protein(CRP)and interleukin-6(IL-6),adiponectin concentration to evaluate their inflammatory state.And retained their stool samples to conduct a 16 S r RNA gene sequencing to analyze the changes in the intestinal flora before and after WTP diet intervention in PCOS,and then found a relationship between the changes and their inflammation and metabolism.Results1.After WTP diet intervention,the clinical manifestations in PCOS patients were improved.Their weight,hirsutism score,and acne score were decreased dramatically,morever,their menstruation became more regular.There was a statistical significance when compared with the pre-intervention,P<0.01.2.After WTP diet intervention,the inflammation and metabolism in PCOS patients were ameliorated.Serum IL-6,total cholesterol,postprandial 2-hour plasma glucose(P2h G),postprandial 2-hour insulin(P2h I),and the insulin resistance index were decreased,while the serum adiponectin concentration showed an upward trend.Compared with the pre-intervention,the difference was statistically significant,P<0.05.3.After the intervention of WTP diet,the intestinal flora in PCOS patients changed.Actinobacteria,Prevotella,and Bifidobacterium were richer,while the relative abundance of Bacteroides was decreased,and Actinobacteria and Bacteroides was considered to be the marker species.4.The gut microbiome was closely related to chronic inflammation and metabolism in PCOS.Serum CRP was negatively correlated with Actinobacteria and Bifidobacteriumlongum.Serum IL-6 showed a positive correlation with Enterobacteriaceae and Proteobacteria,while it has a negative connection with Prevotella.Besides,serum adiponectin was negatively correlated with Megasphaeraelsdenii(P<0.05).Moreover,the insulin resistance index(HOMA-IR)was positively correlated with Proteobacteria and Megasphaeraelsdenii(P<0.05).5.The redundant analysis of the intestinal flora and inflammation and metabolism in PCOS patients illustrated that Escherichia was richer when serum IL-6was higher.And Dialister was more abundant when serum adiponectin was higher,while serum FPG and P2 h I was higher,the relative abundance of Faecalibacterium and Megasphaera were higher,but there was less Bifidobacterium at lower serum FPG and P2 hI.Conclusions1.The gut microbiota is closely related to metabolism and inflammation in PCOS.Serum IL-6 and adiponectin may act as monitoring indicators for PCOS,as it may reflect the structure of intestinal flora in PCOS patients.2.WTP diet intervention can adjust the gut microbiota,ameliorate the inflammation and metabolism in PCOS patients,thus it would be a new therapy for PCOS health mangagement.