Markers of gastrointestinal permeability and dysbiosis in premenopausal women with PCOS: a case–control study

Abstract

ObjectivesAltered intestinal permeability and gut barrier dysfunction have been suggested to play a role in the pathogenetic mechanism of polycystic ovary syndrome (PCOS), the most common endocrine and metabolic condition in reproductive-aged women. However, data on intestinal permeability and dysbiosis of the gut microbiota in PCOS is still limited, with conflicting results. To this end, the concentrations of gastrointestinal permeability and gut dysbiosis markers were analysed in women with PCOS.DesignCase–control study.SettingGeneral community.Participants104 women with PCOS and 203 body mass index (BMI) matched control women at age 46.Primary and secondary outcome measuresSerum levels of zonulin, fatty acid-binding protein 2 (FABP2), urinary levels of indican, and hormonal and metabolic parameters.ResultsSerum levels of zonulin (128.0±17.0 vs 130.9±14.0 ng/mL, p=0.13) and FABP2 (1.5±0.9 vs 1.5±0.7 ng/mL, p=0.63) and urinary levels of indican (9.5±5.5 vs 8.4±4.2 mg/dL, p=0.07) were comparable in women with PCOS and controls in the whole study population. Likewise, when the study population was divided into different BMI groups as normal weight, overweight and obese, the levels of the above markers were comparable between the study groups. After BMI adjustment, zonulin levels correlated with the levels of high-sensitivity C reactive protein and homoeostasis model assessment of insulin resistance (p<0.05) both in women with PCOS and controls.ConclusionsIntestinal permeability markers zonulin and FABP2, and the dysbiosis marker indican do not seem to be altered in women with PCOS at age 46 compared with BMI-matched controls. Serum zonulin levels correlated with BMI, insulin resistance and inflammatory marker levels, but did not segregate women with PCOS and controls. This suggests that metabolic factors, but not PCOS per se, is the driving force of dysbiosis in premenopausal women with PCOS.

A narrative review of the role of gastrointestinal dysbiosis in the pathogenesis of polycystic ovary syndrome

“…Lingaiah et al [ 60 ] reported serum zonulin levels in 104 women from Finland diagnosed with PCOS as part of a longitudinal birth cohort study, compared with 203 BMI-matched non-PCOS controls. All women were aged 46 years at the time of the study.…”

“…The investigators reported comparable serum levels of zonulin in both the study and control populations (128.0±17.0 vs. 130.9±14.0 ng/mL, P =0.13) (ELISA Kit, Immundiagnostik AG). Serum zonulin levels were correlated with BMI, IR, and inflammatory markers [ 60 ]. The generalizability of the results of this study is limited by the methodology and similarity of the study and control groups.…”

Berberine interacts with gut microbiota and its potential therapy for polycystic ovary syndrome

“…40 However, in terms of premenopausal women with PCOS at 46 years old, there was no variation in the serum levels of indicators for gut dysbiosis and gastrointestinal permeability. 41…”

“…Moreover, obese adolescents with PCOS (age 12 to 20 years, BMI > 90th percentile) have a lower richness of Bacteroidaceae and Porphyromonadaceae and higher Streptococcaceae at the family level 40 . However, in terms of premenopausal women with PCOS at 46 years old, there was no variation in the serum levels of indicators for gut dysbiosis and gastrointestinal permeability 41 …”

Meteorin-like Protein and Zonulin in Polycystic Ovary Syndrome: Exploring Associations with Obesity, Metabolic Parameters, and Inflammation

“…Moreno-Navarrete et al [20] unveiled an association of this biomarker with obesity and insulin resistance, revealing elevated levels in obese and prediabetic patients. However, a handful of studies have dissected this biomarker in PCOS women, with findings being inconclusive [21][22][23], thereby leaving the role of zonulin in PCOS pathogenesis unresolved.…”