Effects of body mass index on intestinal floras,endocrine metabolism and insulin resistance in patients with polycystic ovary syndrome
Objective To observe the effects of body mass index(BMI)on intestinal floras,endocrine metabolism and insulin resistance(IR)in patients with polycystic ovary syndrome(PCOS)so as to provide reference for the treatment of such patients.Methods A total of 64 patients with PCOS admitted to Obstetrics and Gynecology Department of Zhong-shan Hospital Affiliated to Xiamen University were enrolled between January 2021 and June 2023.According to the criter-ia of multidisciplinary diagnosis and treatment consensus of obesity in 2021,they were divided into normal weight group(30 cases)and overweight/obesity group(34 cases).The age,menophania age,course of disease,BMI,waist-to-hip ratio(WHR),menstrual cycle,incidence of crinosity and acanthosis,relative abundances of Bacteroides,Firmicutes,Proteobac-teria,Bacteroidetes,Escherichia-Shigella,Blautia and Faecalibacterium were compared among PCOS patients with dif-ferent BMI.The relationship between BMI and intestinal floras at genus level was analyzed with Pearson correlation ana-lysis.The levels of estradiol(E2),testosterone(T),luteinizing hormone(LH),thyroid stimulating hormone(TSH),fasting plasma glucose(FPG),2h postprandial glucose(2hPG),fasting insulin(FINS)and homeostasis model assessment insulin resistance(HOMA-IR)were compared among the PCOS patients with different BMI.The relationship between BMI and endocrine metabolism,IR in PCOS patients were analyzed by Pearson correlation analysis.Results BMI,WHR,incid-ence of crinosity and acanthosis in overweight/obesity group were higher,and menstrual cycle was longer than that in nor-mal weight group(all P＜0.05).The relative abundance of Bacteroidetes in overweight/obesity group was significantly lower,while relative abundance of Firmicutes was significantly higher than in normal weight group(all P＜0.05).The rel-ative abundances of Bacteroides and Escherichia-Shigella in overweight/obesity group were significantly higher,while rel-ative abundances of Blautia and Faecalibacterium were significantly lower than those in normal weight group(all P＜0.05).Pearson correlation analysis showed that relative abundances of Bacteroides and Escherichia-Shigella were pos-itively correlated with BMI,while relative abundances of Blautia and Faecalibacterium were negatively correlated with it(all P＜0.05).The levels of T,TSH,FPG,2hPG,FINS and HOMA-IR in overweight/obesity group were significantly higher,while LH was significantly lower than in normal weight group(all P＜0.05).Pearson correlation analysis showed that TSH was weakly negatively correlated with BMI,T was strongly negatively correlated with BMI,LH,FPG and 2hPG were moderately positively correlated with BMI,FINS and HOMA-IR were strongly positively correlated with BMI(all P＜0.05).Conclusion BMI is related to imbalance of intestinal floras,endocrine metabolism disorders and IR in PCOS patients.In clinical practice,BMI should be rationally regulated to delay disease progression.
Body mass indexPolycystic ovary syndromeIntestinal floraEndocrine metabolismInsulin resistance
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