Unhealthy gut microbiome may be hallmark of PCOS among teens
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Adolescents with obesity and polycystic ovary syndrome have an altered gut microbiome compared with girls without PCOS with a similar BMI and dietary habits, according to findings from a case-control study.
“Teens with PCOS and obesity have an unhealthy stool microbiome pattern, which relates to testosterone as a marker of PCOS, but also worse markers of metabolic disease,” Melanie Cree-Green, MD, PhD, assistant professor of pediatric endocrinology and director of the adolescent PCOS multidisciplinary clinic at the University of Colorado, Anschutz and Children’s Hospital Colorado, told Healio. “This indicates that the gut microbiome is at least affected by PCOS, and future work is needed to determine if changing the microbiome can improve PCOS. It also tells us that these changes occur early in the development of PCOS.”
In a prospective, case-control study, Cress-Green and colleagues analyzed data from 58 adolescent girls with obesity, including 37 with PCOS (mean age, 16 years) and 21 with regular menses and without PCOS (mean age, 15 years). Participants completed a 3-day pediatric activity recall, participated in a diet interview using a food frequency questionnaire and provided fasting blood samples for assessment of glucose, sex hormone concentrations, inflammatory markers and lipid profile. Researchers collected stool samples to analyze bacterial profiles and used permutation-based multivariate analysis of variance to determine differences in overall microbiome composition between groups.
Researchers found that girls with PCOS had decreased alpha-diversity compared with controls (Shannon diversity index, P = .045; Shannon evenness index, P = .0052). Beta-diversity, reflecting overall microbial composition, differed between groups (P < .001).
Girls with PCOS had higher percentage of relative abundance of phyla Actinobacteria (P = .027), lower Bacteroidetes (P = .004), and similar Firmicutes and Proteobacteria compared with controls. Girls with PCOS also had a lower percentage of relative abundance of the Bacteroidaceae (P < .001) and Porphyromonadaceae (P = .024) families and a higher percentage of relative abundance of the Streptococcaceae family (P = .047). Lower bacterial alpha-diversity was associated with higher testosterone concentrations.
“Several individual taxa correlated with testosterone and metabolic measures within PCOS and across the entire cohort,” the researchers wrote.
In receiver operating curve analyses to explore the association of significant taxa with PCOS status at the phyla and family level, researchers found six taxa in which percentage of relative abundance was related to PCOS status, including phyla Bacteroidetes (area under the curve, 0.73), Actinobacteria (AUC, 0.68), and families Lactobacillaceae (AUC, 0.75), Bacteroidaceae (AUC, 0.81), Porphyromonadaceae (AUC, 0.68) and Streptococcaceae (AUC, 0.66). A lower percentage of relative abundance of Bacteroidaceae conferred a 4.4 times likelihood ratio for PCOS diagnosis.
“As in the setting of other infectious or metabolic diseases, we need to test if shifting the microbiome to a more healthy profile via diet or medication improves PCOS or metabolic syndrome,” Cree-Green said. “This would be a completely new way to approach treating PCOS, and needs to be considered for adolescents.” – by Regina Schaffer
For more information:
Melanie Cree-Green, MD, PhD, can be reached at the University of Colorado Anschutz Medical Campus, PO Box 265, 13123 E. 16th Ave., Aurora, CO 80045; email: melanie.green@childrenscolorado.org; Twitter @cree_green.
Disclosures: The authors report no relevant financial disclosures.
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