Gut microbiota in non-obese adolescent girls with polycystic ovary syndrome: effects of randomized treatments

Context: Women and obese adolescent girls with polycystic ovary
syndrome (PCOS) have altered gut microbiota. 
Objective: To study the gut microbiota composition of non-obese
adolescent girls with PCOS and the effects of randomized pharmacological
treatments. Design: Randomized, open-label, single-center
controlled trial.  Settings: Endocrinology Department,
University Hospital.  Participants: 30 girls with PCOS
[age 15.8 years; body mass index (BMI) 25 kg/ m2] and 31 controls [age
15.9 years; BMI 22 kg/ m2].  Intervention: PCOS girls
were randomized to receive an oral contraceptive (OC, N= 15) or
spironolactone-pioglitazone-metformin (SPIOMET, N= 15) for 1
year.  Outcomes: 16S ribosomal subunit gene amplicon
sequencing was used to describe and quantify microbial diversity and
taxonomic profiles in stool samples from all subjects. Samples from 23 out
of 30 girls with PCOS (OC, N= 11; SPIOMET, N= 12) were available for
analysis post-treatment. Correlations between bacterial results and
endocrine-metabolic variables were performed before and after randomized
treatments.  Results: Girls with PCOS had decreased
diversity alpha, altered microbiota pattern and taxonomic profile with
more abundance of Family XI (P= 0.002), and less
abundance of family Prevotellaceae (P= 0.0006) and the
genus Prevotella (P= 0.0001)
and Senegalimassilia (P< 0.0001), as compared to
controls. Family XIabundance related positively to
hepato-visceral fat (R= 0.453; P= 0.0003). SPIOMET treatment, but
not OC, normalized the abundance of Family
XI. Prevotellaceae, Prevotella and Senegalimassilia abundance remained unchanged after either treatment.  Conclusion: SPIOMET’s spectrum of normalizing effects in non-obese girls with PCOS is herewith broadened as to include Family XI abundance in gut microbiota.