Perturbations in gut microbiota composition in patients with polycystic ovary syndrome: a systematic review and meta-analysis

BMC Medicine

Research Article

Jianhui Zhao¹  Yumei Yang²  Ping Sun³  Ping Shuai³  Zhengwei Wan³  Yuping Liu³  Renfang Zhang⁴  Xia Chen⁴  Huimin Zheng⁴  Pan Li⁵  Zixin Lan⁶  Shanwei Lan⁶  Sj Shen⁷  Emad M. El-Omar⁷  Thisun Jayawardana⁷ 

[1] Department of Big Data in Health Science School of Public Health, and Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China;Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China;Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China;Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, No. 32 West Second Section, First Ring Rd., Qing yang Dist, Chengdu, China;Department of Obstetrics and Gynecology, The First People’s Hospital of Foshan, No.81 Lingnan Avenue North, Chancheng District, Foshan, Guangdong Province, China;Department of Obstetrics and Gynecology, The First People’s Hospital of Foshan, No.81 Lingnan Avenue North, Chancheng District, Foshan, Guangdong Province, China;UNSW Microbiome Research Centre, St George and Sutherland Clinical Campuses, UNSW Sydney, Clinical Sciences (WR Pitney) Building, Short St, 2217, Kogarah, NSW, Australia;The Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong Province, China;UNSW Microbiome Research Centre, St George and Sutherland Clinical Campuses, UNSW Sydney, Clinical Sciences (WR Pitney) Building, Short St, 2217, Kogarah, NSW, Australia;

关键词: Polycystic ovary syndrome;    Gut microbiome;    Meta-analysis;    Gut dysbiosis;   

DOI  :  10.1186/s12916-023-02975-8

 received in 2022-11-17, accepted in 2023-07-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe results of human observational studies on the correlation between gut microbiota perturbations and polycystic ovary syndrome (PCOS) have been contradictory. This study aimed to perform the first systematic review and meta-analysis to evaluate the specificity of the gut microbiota in PCOS patients compared to healthy women.MethodsLiterature through May 22, 2023, was searched on PubMed, Web of Science, Medline, Embase, Cochrane Library, and Wiley Online Library databases. Unreported data in diversity indices were filled by downloading and processing raw sequencing data. Systematic review inclusion: original studies were eligible if they applied an observational case-control design, performed gut microbiota analysis and reported diversity or abundance measures, sampled general pre-menopausal women with PCOS, and are longitudinal studies with baseline comparison between PCOS patients and healthy females. Systematic review exclusion: studies that conducted interventional or longitudinal comparisons in the absence of a control group. Two researchers made abstract, full-text, and data extraction decisions, independently. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodologic quality. Hedge’s g standardized mean difference (SMD), confidence intervals (CIs), and heterogeneity (I2) for alpha diversity were calculated. Qualitative syntheses of beta-diversity and microbe alterations were performed.ResultsTwenty-eight studies (n = 1022 patients, n = 928 control) that investigated gut microbiota by collecting stool samples were included, with 26 and 27 studies having provided alpha-diversity and beta-diversity results respectively. A significant decrease in microbial evenness and phylogenetic diversity was observed in PCOS patients when compared with control participants (Shannon index: SMD = − 0.27; 95% CI, − 0.37 to − 0.16; phylogenetic diversity: SMD = − 0.39; 95% CI, -− 0.74 to − 0.03). We also found that reported beta-diversity was inconsistent between studies. Despite heterogeneity in bacterial relative abundance, we observed depletion of Lachnospira and Prevotella and enrichment of Bacteroides, Parabacteroides, Lactobacillus, Fusobacterium, and Escherichia/Shigella in PCOS. Gut dysbiosis in PCOS, which might be characterized by the reduction of short-chain fatty acid (SCFA)-producing and bile-acid-metabolizing bacteria, suggests a shift in balance to favor pro-inflammatory rather than anti-inflammatory bacteria.ConclusionsGut dysbiosis in PCOS is associated with decreased diversity and alterations in bacteria involved in microbiota-host crosstalk.Trial registrationPROSPERO registration: CRD42021285206, May 22, 2023.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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