Gut Microbiota in Adolescent Girls with Polycystic Ovary Syndrome: Effects of Randomized Treatments

Polycystic ovary syndrome (PCOS) in girls is usually accompanied by insulin resistance and hepato-visceral fat excess, even if non-obese. Treatment with a low-dose combination of one mixed anti-androgen/anti-mineralocorticoid (spironolactone) and two anti-diabetic medications (pioglitazone and metformin) (SPIOMET) results in more favourable endocrine-metabolic outcomes than treatment with an oral estro-progestagen contraceptive (OC). Women and obese adolescents with PCOS have altered gut microbiota. We studied the gut microbiota composition of non-obese girls with PCOS and the effects of a randomized treatment with OC or SPIOMET for 1 year.Patients and Methods: 16S ribosomal subunit gene amplicon sequencing was performed in stool samples from 31 controls and 30 girls with PCOS, who were randomized to receive OC (N=15) or SPIOMET (N=15); samples from 23 of the latter 30 girls were available after 1 year on OC (N=12) or SPIOMET (N=11). Clinical and endocrine-metabolic variables were measured before and after intervention.