title: Alterations in Gut Microbiome Composition and Barrier Function Are Associated with Reproductive and Metabolic Defects in Women with Polycystic Ovary Syndrome (PCOS): A Pilot Study.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is a common female endocrinopathy of unclear origin characterized by hyperandrogenism, oligo-/anovulation, and ovarian cysts. Women with PCOS frequently display overweight, insulin resistance, and systemic low-grade inflammation. We hypothesized that endotoxemia resulting from a leaky gut is associated with inflammation, insulin resistance, fat accumulation, and hyperandrogenemia in PCOS. In this pilot study, we compared the stool microbiome, gut permeability, and inflammatory status of women with PCOS and healthy controls.
  
  
  METHODS
  16S rRNA gene amplicon sequencing was performed on stool samples from 24 PCOS patients and 19 healthy controls. Data processing and microbiome analysis were conducted in mothur and QIIME using different relative abundance cut-offs. Gut barrier integrity, endotoxemia, and inflammatory status were evaluated using serum and stool markers and associations with reproductive, metabolic, and anthropometric parameters were investigated.
  
  
  RESULTS
  The stool microbiome of PCOS patients showed a lower diversity and an altered phylogenetic composition compared to controls. We did not observe significant differences in any taxa with a relative abundance>1%. When looking at rare taxa, the relative abundance of bacteria from the phylum Tenericutes, the order ML615J-28 (phylum Tenericutes) and the family S24-7 (phylum Bacteroidetes) was significantly lower and associated with reproductive parameters in PCOS patients. Patients showed alterations in some, but not all markers of gut barrier function and endotoxemia.
  
  
  CONCLUSIONS
  Patients with PCOS have a lower diversity and an altered phylogenetic profile in their stool microbiome, which is associated with clinical parameters. Gut barrier dysfunction and endotoxemia were not driving factors in this patient cohort, but may contribute to the clinical phenotype in certain PCOS patients.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
authors.forename: Lisa
authors.identifier: http://orcid.org/0000-0001-7732-3869
authors.initials: L
authors.lastname: Lindheim
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
authors.forename: Mina
authors.initials: M
authors.lastname: Bashir
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Münzker
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Trummer
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Zachhuber
authors.affiliation: Department of Surgery, Division of Transplantation Surgery, Medical University Graz, Graz, Austria.|Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
authors.forename: Bettina
authors.initials: B
authors.lastname: Leber
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University Graz, Graz, Austria.
authors.forename: Angela
authors.initials: A
authors.lastname: Horvath
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.|Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
authors.affiliation: Institute of Pathology, Medical University Graz, Graz, Austria.|BioTechMed, Interuniversity Cooperation, Graz, Austria.
authors.forename: Gregor
authors.initials: G
authors.lastname: Gorkiewicz
authors.affiliation: Center for Biomarker Research in Medicine (CBmed), Graz, Austria.|Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University Graz, Graz, Austria.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Stadlbauer
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.|Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
mesh_terms: D000328:Adult; D000886:Anthropometry; D041963:Bacteroidetes / Q000145:classification / Q000302:isolation & purification; D016022:Case-Control Studies; D005243:Feces / Q000382:microbiology; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007249:Inflammation; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000378:metabolism / Q000382:microbiology*; D025341:Principal Component Analysis; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D011795:Surveys and Questionnaires; D008973:Tenericutes / Q000145:classification / Q000302:isolation & purification
chemical_list: D012336:RNA, Ribosomal, 16S