Analysis Of Gut Microbial Community In Polycystic Ovary Syndrome With Insulin Resistance

BackgroundPolycystic ovary syndrome(PCOS)is a common heterogeneous endocrine disease that affects approximately 8% to 13% of women of child-bearing age worldwide.At present,the cause of the disease is unknown,and it may involve many aspects such as environment,genetic factors,neuroendocrine,behavioral factors,immune and metabolic dysfunction,etc,which will affect women’s lifelong health and quality of life.Recent studies have shown that the composition of the intestinal flora of women with PCOS has changed significantly.Moreover,the imbalance of intestinal flora is closely related to clinical symptoms such as obesity and Insulin resistance(IR).Objectives1.This study hopes to have a preliminary understanding of the differences in the composition of intestinal bacteria between healthy women,PCOS with IR and PCOS without IR;2.Be able to further analyze the correlation between each bacteria and clinical parameters such as patient body mass index,waist-to-hip ratio,inflammation index,blood lipid metabolism,sex hormone level,etc,to provide reference for follow-up research;3.It is hoped that the results of this experiment can provide a theoretical basis for the treatment of PCOS patients who target the intestinal flora to improve the symptoms of the PCOS population.MethodsNewly diagnosed women with PCOS were recruited and divided into IR-PCOS group and NIR-PCOS group according to the homeostasis model insulin resistance index(HOMA-IR).And age-matched women with normal ovulation were selected as healthy controls.BY collecting volunteers’ general information,blood samples and rectal swab samples,to analyze the characteristics of clinical parameters,amplify the 16 S r RNA V3-V4 fragments of the rectal swab samples,and then perform high-throughput sequencing to analyze the composition characteristics of the intestinal flora of each group of subjects and their correlation with clinical parameters.Results1.Compared with healthy women,plasma testosterone,luteinizing hormone,ratio of luteinizing hormone to follicle stimulating hormone and fasting insulin in IR-PCOS group and NIR-PCOS group were significantly increased(P<0.05).Among them,compared with the NIR-PCOS group,the above indicators in the IR-PCOS group increased more significantly(P<0.05).Compared with the healthy control group,PCOS patients showed a certain degree of dyslipidemia,specifically manifested as a significant increase in serum total cholesterol and low-density lipoprotein,while a significant decrease in high-density lipoprotein levels(P<0.05),but IR-PCOS There was no significant difference between the IR-PCOS group and the NIR-PCOS group(P>0.05);the tumor necrosis factor level of the PCOS group was significantly higher than that of the healthy HC group,and reached a higher level in the IR-PCOS group(P<0.05);2.The structure of the intestinal flora of PCOS patients was significantly changed compared with that of healthy women in the control group.The diversity was reduced(P<0.05).The relative abundance of Bacteroides in the flora was significantly higher than that of the HC group(P<0.05),the phylum Firmicutes was significantly reduced(P<0.05);3.The decrease in the diversity of intestinal flora in the IR-PCOS group was greater than that in the NIR-PCOS group(P<0.05),and the relative abundance of Bacteroides phylum was also significantly higher than that in the NIR-PCOS group(P<0.05).4.In the flora,Campylobacter,Bacteroides,Desulfobacteria are positively correlated with testosterone,luteinizing hormone,luteinizing hormone and follicle stimulating hormone ratio,body mass index,insulin resistance index,tumor necrosis factor,and dyslipidemia.The phylum Proteobacteria,Actinomycetes and Chloroflexus are negatively correlated with them.Among them,the correlation of Campylobacter and the ratio of luteinizing hormone to follicle stimulating hormone,Proteobacteria and body mass index,Chloroflexus and serum total cholesterol were statistically significant(P<0.05).Conclusions1.PCOS patients have sex hormone disorders,dyslipidemia and elevated TNF-α.PCOS patients with IR have more significant increases in LH,LH/FSH,FINS and TNF-α.2.The diversity of the intestinal flora of the PCOS population is lower than that of the healthy population,and the diversity of PCOS patients with IR is lower than that of PCOS patients without IR.3.The relative abundance of Bacteroides in the intestinal flora of the PCOS population has increased,while the increase in PCOS patients with IR is higher.4.There was a positive correlation between Campylobacter and LH/FSH,a negative correlation between Proteobacteria and BMI,and a negative correlation between Chloroflexus and TC in PCOS patients.