Abstract
Background: Polycystic ovary syndrome (PCOS) affects 5–20% of women of reproductive age worldwide and is associated with disorders of glucose metabolism. Hormone and metabolic signaling may be influenced by phytoestrogens, such as isoflavones. Their endocrine effects may modify symptom penetrance in PCOS. Equol is one of the most active isoflavone metabolites, produced by intestinal bacteria, and acts as a selective estrogen receptor modulator. Method: In this interventional study of clinical and biochemical characterization, urine isoflavone levels were measured in PCOS and control women before and three days after a defined isoflavone intervention via soy milk. In this interventional study, bacterial equol production was evaluated using the log(equol: daidzein ratio) and microbiome, metabolic, and predicted metagenome analyses were performed. Results: After isoflavone intervention, predicted stool metagenomic pathways, microbial alpha diversity, and glucose homeostasis in PCOS improved resembling the profile of the control group at baseline. In the whole cohort, larger equol production was associated with lower androgen as well as fertility markers. Conclusion: The dynamics in our metabolic, microbiome, and predicted metagenomic profiles underline the importance of external phytohormones on PCOS characteristics and a potential therapeutic approach or prebiotic in the future.
Highlights
Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women, affecting 5–20% already from reproductive age worldwide, with phenotypes of various degrees of hyperandrogenism, anovulation and polycystic ovarian morphology [1,2].Though the etiology is still under investigation, chronic pro-inflammatory status and a tendency toward insulin resistance [3,4,5] play a critical role in the development of harmful long-term consequences such as diabetes mellitus type 2 (T2DM) and the associated risk of pregnancy complications such as gestational diabetes [6], and increased risk of cardiovascular disease (CVD) [7]
The clinical phenotype is further worsened as a result of excessive ovarian and adrenal androgen release as well as hepatic sex hormone-binding globulin (SHBG) [12] which secretion is independent of obesity [13]
We found of an improvement in like flavonoid biosynthesis
Summary
Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women, affecting 5–20% already from reproductive age worldwide, with phenotypes of various degrees of hyperandrogenism, anovulation and polycystic ovarian morphology [1,2].Though the etiology is still under investigation, chronic pro-inflammatory status and a tendency toward insulin resistance [3,4,5] play a critical role in the development of harmful long-term consequences such as diabetes mellitus type 2 (T2DM) and the associated risk of pregnancy complications such as gestational diabetes [6], and increased risk of cardiovascular disease (CVD) [7]. Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women, affecting 5–20% already from reproductive age worldwide, with phenotypes of various degrees of hyperandrogenism, anovulation and polycystic ovarian morphology [1,2]. Polycystic ovary syndrome (PCOS) affects 5–20% of women of reproductive age worldwide and is associated with disorders of glucose metabolism. Method: In this interventional study of clinical and biochemical characterization, urine isoflavone levels were measured in PCOS and control women before and three days after a defined isoflavone intervention via soy milk. In this interventional study, bacterial equol production was evaluated using the log(equol: daidzein ratio) and microbiome, metabolic, and predicted metagenome analyses were performed
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