Moxibustion May Improves Polycystic Ovary Syndrome through Modulation of Gut Microbiota-Metabolite Interaction

Polycystic ovary syndrome (PCOS) is a common systemic disorder related to endocrine disorders, affecting the fertility of women of childbearing age. Its pathogenesis is closely related to disorders of glucose and lipid metabolism, gut microbiota, and insulin resistance. Modern medicine offers treatments such as pioglitazone, metformin, and spironolactone to address specific PCOS symptoms, whereas in Chinese clinical practice, moxibustion is commonly used for treating PCOS. In this study, we established a dehydroepiandrosterone (DHEA) -induced PCOS rat model and assessed the effects of moxibustion on the gut microbiota and metabolomic characteristics of PCOS. We randomly assigned 36 specific pathogen-free female Sprague-Dawley rats to four groups: the normal control group (CTRL), PCOS model group (PCOS), moxibustion treatment group (MBT), and metformin treatment group (MET). MBT group rats were treated with moxibustion, while MET group rats were treated with metformin gavage. After 2 weeks of intervention, we assessed the morphological alterations in ovarian tissue, and measured specific parameters including the contents of serum testosterone, fasting blood glucose and fasting insulin. Additionally, the insulin sensitivity index (ISI) and the homeostasis model assessment of insulin resistance index (HOMA-IR) were calculated. We used 16S ribosomal DNA sequencing for assessing the gut microbiota, 1H NMR spectroscopy for evaluating metabolic changes, and Spearman correlation analysis for investigating the associations between metabolites and gut microbiota composition. The results indicate that moxibustion therapy significantly improves ovarian dysfunction and insulin resistance induced by dehydroepiandrosterone (DHEA) in PCOS rats. There were significant differences in the composition of gut microbiota and faecal metabolite profiles between CTRL and PCOS rats, and most of these differences decreased after moxibustion intervention. Moxibustion altered the gut microbiota by increasing the abundance of UCG-005 and Turicibacter and decreasing the abundance of Desulfovibrio. Additionally, moxibustion promoted elevated levels of short-chain fatty acids (acetic acid, propionic acid, and butyric acid) associated with gut microbiota in PCOS rats. The findings suggest that moxibustion may alleviate DHEA-induced PCOS by regulating metabolic levels, restoring gut microbiota balance, and modulating interactions between gut microbiota and host metabolites.