DataSheet_1_Clinical Manifestations of Polycystic Ovary Syndrome and Associations With the Vaginal Microbiome: A Cross-Sectional Based Exploratory Study.docx

BackgroundPrevious studies suggest that the vaginal microbiome is associated with polycystic ovary syndrome (PCOS). However, the clinical manifestations of PCOS are heterogeneous. Whether the vaginal microbiome is related with different clinical symptoms was unknown.
Materials and MethodsIn this cross-sectional study, 89 female patients with PCOS admitted to Zhongda Hospital (Nanjing, China) were included. Basic demographic information, health-related behaviors, clinical manifestations and sex hormone levels were comprehensively recorded for all patients. Vaginal swabs were acquired for microbiota sequencing of the V3–V4 region of the 16S rRNA gene.
ResultsThe prevalence of bacterial vaginitis and vulvovaginal candidiasis was 15.7% and 13.5%, respectively, within the PCOS patients, which were the most important factors affecting the vaginal microbiome (permutational multivariate analysis of variance test, R2 = 0.108, P = 0.001). The vaginal microbiome was associated with specific clinical manifestations of PCOS, including acanthosis nigricans, intermenstrual bleeding, pregnancy history, testosterone level and anti-müllerian hormone level, with P values < 0.05. The abundance of Lactobacillus crispatus was higher (P = 0.010) while that of Lactobacillus iners was lower (P = 0.036) among PCOS patients with elevated testosterone levels. Other potential bacterial biomarkers were not statistically significant after adjusting for confounding factors. No evidence of associations of other common manifestations of PCOS, such as obesity and acne, with the vaginal microbiome was obtained.
ConclusionVaginal bacterial species among PCOS patients with variable clinical manifestations, especially differences in testosterone levels, are distinct. Further studies are essential to investigate the microbiota and molecular mechanisms underpinning this disease.

研究背景
既往研究表明，阴道微生物组（vaginal microbiome）与多囊卵巢综合征（polycystic ovary syndrome, PCOS）相关。然而，多囊卵巢综合征的临床表现具有异质性，目前尚不清楚阴道微生物组是否与不同的临床症状存在关联。
材料与方法
本横断面研究纳入了中国南京中大医院收治的89名多囊卵巢综合征女性患者。研究人员全面收集了所有患者的基本人口学信息、健康相关行为、临床表现以及性激素水平等数据。采集阴道拭子样本，对16S rRNA基因的V3-V4区进行微生物组测序。
研究结果
多囊卵巢综合征患者中，细菌性阴道病和外阴阴道假丝酵母菌病的患病率分别为15.7%和13.5%，这是影响阴道微生物组的最主要因素（置换多元方差分析，R²=0.108，P=0.001）。阴道微生物组与多囊卵巢综合征的特定临床表现存在关联，包括黑棘皮症、经间期出血、妊娠史、睾酮水平以及抗缪勒管激素水平（所有P值均<0.05）。在睾酮水平升高的多囊卵巢综合征患者中，卷曲乳杆菌（Lactobacillus crispatus）的丰度更高（P=0.010），而惰性乳杆菌（Lactobacillus iners）的丰度更低（P=0.036）。在调整混杂因素后，其他潜在的细菌生物标志物未显示出统计学显著性。未发现多囊卵巢综合征的其他常见临床表现（如肥胖、痤疮）与阴道微生物组存在关联的证据。
研究结论
表现为不同临床特征的多囊卵巢综合征患者，其阴道菌群存在显著差异，尤以睾酮水平差异最为突出。未来需开展进一步研究以阐明该疾病相关的微生物组特征及分子机制。