Gut microbiota in non-obese adolescent girls with polycystic ovary syndrome: effects of randomized treatments

<p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Context:</b> Women and obese adolescent girls with polycystic ovary syndrome (PCOS) have altered gut microbiota. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Objective:</b> To study the gut microbiota composition of non-obese adolescent girls with PCOS and the effects of randomized pharmacological treatments.</span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Design:</b> Randomized, open-label, single-center controlled trial. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Settings:</b> Endocrinology Department, University Hospital. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Participants: </b>30 girls with PCOS [age 15.8 years; body mass index (BMI) 25 kg/ m²] and 31 controls [age 15.9 years; BMI 22 kg/ m²]. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Intervention:</b> PCOS girls were randomized to receive an oral contraceptive (OC, N= 15) or spironolactone-pioglitazone-metformin (SPIOMET, N= 15) for 1 year. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Outcomes: </b>16S ribosomal subunit gene amplicon sequencing was used to describe and quantify microbial diversity and taxonomic profiles in stool samples from all subjects. Samples from 23 out of 30 girls with PCOS (OC, N= 11; SPIOMET, N= 12) were available for analysis post-treatment. Correlations between bacterial results and endocrine-metabolic variables were performed before and after randomized treatments. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Results:</b> Girls with PCOS had decreased diversity alpha, altered microbiota pattern and taxonomic profile with more abundance of <i>Family XI</i> (<i>P</i>= 0.002), and less abundance of family <i>Prevotellaceae</i> (<i>P</i>= 0.0006) and the genus <i>Prevotella</i> (<i>P</i>= 0.0001) and <i>Senegalimassilia</i> (<i>P</i>&lt; 0.0001), as compared to controls. <i>Family XI</i>abundance related positively to hepato-visceral fat (R= 0.453; <i>P</i>= 0.0003). SPIOMET treatment, but not OC, normalized the abundance of <i>Family XI</i>. <i>Prevotellaceae</i>, <i>Prevotella</i> and <i>Senegalimassilia</i> abundance remained unchanged after either treatment. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Conclusion:</b> SPIOMET's spectrum of normalizing effects in non-obese girls with PCOS is herewith broadened as to include <i>Family XI</i> abundance in gut microbiota. </span></span></span></span></span></span></span></span></span></span></span></p>