Intestinal Microbiota, Metabolites and Brain Network Structure Changes in Polycystic Ovary Syndrome patients

Background Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women. We investigated gut microbiota and brain network alterations in PCOS patients. Methods We enrolled 26 PCOS patients and 20 healthy controls, collecting clinical data, blood, and stool samples. Serum hormones, biochemical markers, inflammatory factors (e.g., IL-6, TNFα), and short-chain fatty acids were analyzed. A subset (12 PCOS, 18 controls) underwent fMRI to assess brain network differences. Results We discovered that the circulating inflammatory factors IL-6 and TNFα in obese PCOS patients significantly increased. Gal-3 increased significantly in PCOS patients. Sutterella is significantly related to a number of clinical indicators in PCOS, which might be implicated in the occurrence and progression of PCOS. Based on LC-MS metabonomic methods, we screened 28 differential metabolites in PCOS and analyzed the main metabolic pathways of these metabolites. By analyzing the fMRI results, we found that the FCD index indicated that the activation of the right precuneus in PCOS patients was higher than that in the healthy controls, and the ALFF index indicated that the activation of the left postcentral gyrus in PCOS patients was higher than that in the healthy controls. The CBF of the healthy controls in the left lingual gyrus and the right Parietal_Inf_R were significantly greater than that of the PCOS patients, and there was a significant difference in the Synchronization index. Conclusions PCOS involves gut microbiota dysbiosis, metabolic disturbances, and altered brain network connectivity, our research offers new insights into its pathogenesis.