Metabolic-endocrine correlates of gut-brain axis mediators in polycystic ovary syndrome: A case-control study.
Level 4 - case-series / case-control
Case-control study comparing biomarker levels between clinical cases and matched controls
PubMed 42076786 · doi:10.1111/jne.70180
What was done
Researchers conducted a case-control study in 190 women aged 18–40 years, comprising 96 women diagnosed with polycystic ovary syndrome (PCOS) by 2003 Rotterdam criteria and 94 age-matched healthy controls. Serum concentrations of gut-brain axis mediators—kisspeptin, ghrelin, serotonin, and peptide tyrosine tyrosine (PYY)—were quantified using ELISA alongside clinical, hormonal, metabolic, and inflammatory markers.
What was found
Women with PCOS had significantly higher kisspeptin and lower ghrelin and serotonin levels than controls (p < .05), with no significant difference in PYY. Kisspeptin was inversely correlated with ghrelin (r = -.237, p = .003) and serotonin (r = -.303, p < .001), and these peptides correlated with fasting insulin, glucose, HOMA-IR, TyG, and TyG-BMI ratios. After adjusting for BMI, lower ghrelin (OR = 0.661, p = .008) and serotonin (OR = 0.814, p = .016) remained independently associated with PCOS. Kisspeptin had an area under the ROC curve of 0.768 (95% CI: 0.696–0.839; 82.4% sensitivity, 59.0% specificity) for PCOS discrimination, while the other peptides demonstrated lower AUCs.
Why it matters
The findings demonstrate a distinct peptide profile involving elevated kisspeptin and reduced ghrelin and serotonin in PCOS. This supports the concept of PCOS as a neuro-metabolic disorder involving gut-brain axis signaling disruption independent of obesity.
Limits
The observational case-control design precludes causal inference regarding whether peptide alterations drive metabolic dysfunction or arise as secondary consequences. The abstract does not provide absolute peptide concentration values, and the single-biomarker diagnostic performance was moderate to weak, notably kisspeptin's low specificity (59.0%).
Cited by
- supports Women diagnosed with polycystic ovary syndrome (PCOS) exhibit an altered gut microbiome and disrupted gut-brain axis compared to healthy controls.