University of Oulu

Kreete Lüll, Riikka K Arffman, Alberto Sola-Leyva, Nerea M Molina, Oliver Aasmets, Karl-Heinz Herzig, Julio Plaza-Díaz, Stephen Franks, Laure Morin-Papunen, Juha S Tapanainen, Andres Salumets, Signe Altmäe, Terhi T Piltonen, Elin Org, The Gut Microbiome in Polycystic Ovary Syndrome and Its Association with Metabolic Traits, The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 3, March 2021, Pages 858–871,

The gut microbiome in polycystic ovary syndrome and its association with metabolic traits

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Author: Lüll, Kreete1,2; Arffman, Riikka K.3; Sola-Leyva, Alberto4,5;
Organizations: 1Institute of Genomics, Estonian Genome Centre, University of Tartu, Tartu, Estonia
2Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
3Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
4Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
5Instituto de Investigación Biosanitaria ibs GRANADA, Granada, Spain
6Research Unit of Biomedicine, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
7Department of Paediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań, Poland
8Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
9Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
10Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
11Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
12Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
13Competence Centre on Health Technologies, Tartu, Estonia
14Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, Oulu, University Hospital, University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
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Language: English
Published: Endocrine society, 2021
Publish Date: 2022-01-04


Context: Despite the gut microbiome being widely studied in metabolic diseases, its role in polycystic ovary syndrome (PCOS) has been scarcely investigated.

Objective: Compare the gut microbiome in late fertile age women with and without PCOS and investigate whether changes in the gut microbiome correlate with PCOS-related metabolic parameters.

Design: Prospective, case–control study using the Northern Finland Birth Cohort 1966.

Setting: General community.

Participants: A total of 102 PCOS women and 201 age- and body mass index (BMI)-matched non-PCOS control women. Clinical and biochemical characteristics of the participants were assessed at ages 31 and 46 and analyzed in the context of gut microbiome data at the age of 46.

Intervention: (s): None

Main outcome measure(s): Bacterial diversity, relative abundance, and correlations with PCOS-related metabolic measures.

Results: Bacterial diversity indices did not differ significantly between PCOS and controls (Shannon diversity P = .979, unweighted UniFrac P = .175). Four genera whose balance helps to differentiate between PCOS and non-PCOS were identified. In the whole cohort, the abundance of 2 genera from Clostridiales, Ruminococcaceae UCG-002, and Clostridiales Family XIII AD3011 group, were correlated with several PCOS-related markers. Prediabetic PCOS women had significantly lower alpha diversity (Shannon diversity P = .018) and markedly increased abundance of genus Dorea (false discovery rate = 0.03) compared with women with normal glucose tolerance.

Conclusions: PCOS and non-PCOS women at late fertile age with similar BMI do not significantly differ in their gut microbial profiles. However, there are significant microbial changes in PCOS individuals depending on their metabolic health.

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Series: Journal of clinical endocrinology & metabolism
ISSN: 0021-972X
ISSN-E: 1945-7197
ISSN-L: 0021-972X
Volume: 106
Issue: 3
Pages: 858 - 871
DOI: 10.1210/clinem/dgaa848
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was funded by Estonian Research Council grants PUT 1371 (to E.O.), IUT34-16 (to A.S.), Enterprise Estonia grant no. EU48695 (to A.S.), and EMBO Installation grant 3573 (to E.O. and supported K.L., O.A.). E.O. was supported by European Regional Development Fund project no. 15-0012 GENTRANSMED, Estonian Center of Genomics/Roadmap II project no. 16-0125 and Estonian Research Council grant PRG 687. K.L. was supported by The European Regional Development Fund. S.A. was supported by the Spanish Ministry of Economy, Industry and Competitiveness (MINECO) and European Regional Development Fund (FEDER): grants RYC-2016-21199 and ENDORE (SAF2017-87526-R); and by FEDER/Junta de Andalucía-Consejería de Economía y Conocimiento: MENDO (B-CTS-500-UGR18). A.S.L. and N.M.M. are funded by the Spanish Ministry of Science, Innovation and Universities: PRE2018-0854409 (A.S.L.) and FPU19/01638 (N.M.M.). T.T.P. and R.K.A. are funded by Finnish Academy and Sigrid Juselius Foundation. NFBC1966 received financial support from University of Oulu grant no. 65354, Oulu University Hospital grant no. 2/97, 8/97, Ministry of Health and Social Affairs grant no. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland grant no. 50621, 54231. NFBC1966 received financial support from University of Oulu grant no. 24000692, Oulu University Hospital grant no. 24301140, ERDF European Regional Development Fund grant no. 539/2010 A31592. S.F. was supported by The Genesis Research Trust UK.
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