Chen, W., & Pang, Y. (2021). Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites. Metabolites, 11(12), 869. https://doi.org/10.3390/metabo11120869
Chen W, Pang Y. Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites. Metabolites. 2021;11(12):869. doi:10.3390/metabo11120869
Chen, Weixuan, and Yanli Pang. "Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites." Metabolites, vol. 11, no. 12, 2021, pp. 869.
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RRM Academy Synopsis
PCOS Metabolic Symptoms Tied to Gut Bacteria and Metabolites
Metabolic syndrome affects 43 out of 100 adult women with PCOS (polycystic ovary syndrome), also called PMOS (Polyendocrine Metabolic Ovarian Syndrome). Insulin resistance has been reported in about 50 to 80 out of 100 women with PCOS. This 2021 review in the journal Metabolites links these problems to gut bacteria and their byproducts.
Key Findings
Metabolic syndrome affects 43 out of 100 adult women and nearly one-third of teenage girls with PCOS.
Insulin resistance has been reported in 50 to 80 out of 100 women with PCOS, varying by phenotype and population studied.
Dyslipidemia, abnormal levels of blood fats such as cholesterol and triglycerides, occurs in about 70 out of 100 women with PCOS.
PCOS itself affects about 6 out of 100 women under older diagnostic criteria and up to 20 out of 100 under the Rotterdam criteria used today.
Gut bacteria and byproducts such as bile acids, short-chain fatty acids and branched-chain amino acids differ between women with PCOS and women without it.
Interpretation
This is a narrative review. The authors gathered findings from many research groups. They examined gut bacteria and their byproducts in women with PCOS, using human studies and animal models. The authors say some findings are mixed, such as how certain amino acids affect insulin resistance. The findings support more research into these gut-bacteria links in PCOS.
RRM Context
Restorative reproductive medicine evaluates the metabolic drivers of PCOS, including insulin resistance, high androgen levels and weight. Doctors weigh these findings along with ovarian findings to treat the root cause. The gut bacteria and byproducts described in this review add another piece to that picture for women with PCOS.
Our editorial summary of this paper, not the article's abstract.
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases among women of reproductive age and is associated with many metabolic manifestations, such as obesity, insulin resistance (IR) and hyperandrogenism. The underlying pathogenesis of these metabolic symptoms has not yet been fully elucidated. With the application of metabolomics techniques, a variety of metabolite changes have been observed in the serum and follicular fluid (FF) of PCOS patients and animal models. Changes in metabolites result from the daily diet and occur during uncommon physiological routines. However, some of these metabolite changes may provide evidence to explain possible mechanisms and new approaches for prevention and therapy. This article reviews the pathogenesis of PCOS metabolic symptoms and the relationship between metabolites and the pathophysiology of PCOS. Furthermore, the potential clinical application of some specific metabolites will be discussed.
PMOS / PCOS has four diagnostic phenotypes and distinct metabolic, reproductive, and mental health implications. How RRM-trained clinicians approach diagnosis and treatment differently.
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