Abstract
PurposeSleeve gastrectomy (SG) is a surgical intervention for polycystic ovary syndrome (PCOS), especially for patients with obesity. Here, we explored the effects of SG on the gut microbiota of rats with PCOS and investigated the association between the intestinal flora and efficacy of SG in PCOS.MethodsDehydroepiandrosterone (DHEA) injection was administered alone and in combination with a high-fat diet to induce PCOS in rats. SG was performed in rats with PCOS, and the effects of SG on the fecal and gut microbiota and the short-chain fatty acid (SCFA) content were observed. Furthermore, the association among gut microbiota, SCFA content and hyperandrogenism or other hallmarks of PCOS was evaluated.ResultsThe abundance of Firmicutes reduced and that of Bacteroidetes increased in response to SG in the DHEA-induced PCOS rat model. At the genus level, the abundances of Bacteroides and Blautia increased and those of Ruminococcus, Clostridium, and Alistipes reduced distinctly in the PCOS-SG groups. Moreover, the levels of fecal SCFAs, especially butyric acid, reduced after SG. SG significantly ameliorated PCOS-related symptoms such as hyperandrogenism, disrupted ovary function, and impaired glucose tolerance. Bacteroides and Blautia exhibited a negative correlation and Ruminococcus, Clostridium, and Alistipes exhibited a positive correlation with the levels of fecal SCFAs, luteinizing hormone, testosterone, and inflammatory factors.ConclusionsThe amelioration of PCOS-related reproductive and metabolic disorders following SG was associated with the regulation of microbial taxa and SCFA content. Our findings provide a novel perspective on the microbial mechanisms in PCOS after SG.
Highlights
Polycystic ovary syndrome (PCOS) is a heterogeneous condition characterized by hyperandrogenism, oligo/anovulation, and polycystic ovaries [1]
There were no significant differences between the Chao1 indices of CON and PCOS rats pre-surgery or between those of DHFSg and DHFSh rats post-surgery (Figure 1A)
There were no significant differences between the parameters obtained for the CON and PCOS groups (Figures 1B, C) or those obtained for the corresponding Sleeve gastrectomy (SG) and sham surgery groups (Figures 1B, C)
Summary
Polycystic ovary syndrome (PCOS) is a heterogeneous condition characterized by hyperandrogenism, oligo/anovulation, and polycystic ovaries [1]. It is one of the major causes of metabolic disorders in women of reproductive age. Only a few studies have shown that bariatric surgery may be beneficial for individuals with PCOS [3, 4]. Multiple studies have suggested that significant and persistent weight loss is an important outcome of metabolic surgery that improves PCOS. Some studies have suggested that alterations in the expression of inflammatory factors [5], gut hormones [6], and adipose hormones [7] contribute to the benefits of bariatric surgery in patients with PCOS. Sleeve gastrectomy (SG) is a popular bariatric surgical procedure; the suitability and potential mechanisms by which SG improves PCOS remain unknown
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