BACKGROUND Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder, and its pathogenesis is still under debate. Trimethylamine-N-oxide (TMAO) is a small, organic compound generated by the gut microbiome with a hypothesized relation to insulin resistance (IR) and low-grade inflammation in PCOS. By comparing plasma TMAO levels in non-PCOS participants and PCOS patients without hyperandrogenism (HA), we aimed to determine whether plasma TMAO levels correlate with PCOS without HA and to analyze their relationship with low-grade inflammation and IR. METHODS A total of 27 PCOS patients without HA and 23 non-PCOS participants were enrolled in this study and subdivided into "nonobese" and "obese" arms for each group. Levels of plasma TMAO were quantified, and basic clinical characteristics and plasma biomarkers of inflammation were assessed. RESULTS First, plasma TMAO levels, insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were higher in PCOS patients without HA, especially in the obese subgroup. Second, the levels of the inflammatory factors interleukin (IL)-17A, IL-18 and interferon gamma (IFN-γ) were significantly increased in obese PCOS patients without HA. Third, plasma TMAO levels were associated with body mass index (BMI) in the normal-weight groups, and the obese groups had higher fasting plasma insulin (FINS) and HOMA-IR values. Finally, logistic regression showed that the plasma levels of TMAO and luteinizing hormone/follicle-stimulating hormone (LH/FSH) were independent predictors of PCOS and indicated an increased risk of PCOS. CONCLUSIONS Elevated plasma TMAO levels may be associated with the pathogenesis of PCOS without HA and correlated with increased systemic inflammation. Further studies are needed to determine the suitability of TMAO as a predictive biomarker and to identify possible therapies for PCOS.

中文翻译：

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没有高雄激素血症的PCOS与更高的血浆三甲胺N-氧化物水平有关。

背景技术多囊卵巢综合征（PCOS）是一种内分泌和代谢紊乱，其发病机理仍在争论中。三甲胺-N-氧化物（TMAO）是由肠道微生物组产生的一种小的有机化合物，与PCOS中的胰岛素抵抗（IR）和低度炎症有关。通过比较非PCOS参与者和无高雄激素血症（HA）的PCOS患者的血浆TMAO水平，我们旨在确定血浆TMAO水平是否与无HA的PCOS相关，并分析其与低度炎症和IR的关系。方法本研究共纳入27例无HA的PCOS患者和23例非PCOS参与者，并按每组分为“非肥胖”和“肥胖”两组。量化血浆TMAO的水平，并评估了炎症的基本临床特征和血浆生物标志物。结果首先，没有HA的PCOS患者，尤其是肥胖亚组的血浆TMAO水平，胰岛素水平和稳态模型评估的胰岛素抵抗（HOMA-IR）值较高。其次，在没有HA的肥胖PCOS患者中，炎症因子白介素（IL）-17A，IL-18和干扰素γ（IFN-γ）的水平显着升高。第三，正常体重组血浆TMAO水平与体重指数（BMI）相关，肥胖组空腹血浆胰岛素（FINS）和HOMA-IR值较高。最后，逻辑回归表明，TMAO和促黄体生成素/促卵泡激素（LH / FSH）的血浆水平是PCOS的独立预测因子，提示PCOS风险增加。结论血浆TMAO水平升高可能与无HA的PCOS发病有关，并与全身性炎症增加有关。需要进行进一步的研究以确定TMAO作为预测性生物标志物的适用性，并确定PCOS的可能疗法。