High-Fiber Diet or Combined With Acarbose Alleviates Heterogeneous Phenotypes of Polycystic Ovary Syndrome by Regulating Gut Microbiota
Open accessAbstract
Objective Gut microbial dysbiosis is associated with high heterogeneity of polycystic ovary syndrome (PCOS); however, studies about gut microbiota targeted clinical intervention in PCOS are limited. Our study aimed to evaluate the effects of high-fiber diet or combined with acarbose on the clinical phenotypes of PCOS, focusing on the possible influence of gut microbiota in this process. Methods Twenty-five patients with PCOS were recruited and randomly divided into two groups, W group (n = 14) received the WTP diet (a high-fiber diet composed of whole grains, traditional Chinese medicinal foods, and prebiotics), and A group (n = 11) received the WTP diet combined with acarbose. The follow-up time was 12 weeks. The sex hormonal and glycolipid metabolic parameters, inflammatory factors, brain–gut peptides, and alteration of gut microbiota were evaluated. Results The PCOS clinical phenotypes, inflammatory state, and brain–gut peptides secretion were all alleviated in both groups, while the hyperandrogenism, insulin resistance, and brain–gut peptides secretion were better improved in the A group. Alpha and beta diversities were altered more significantly in the A group. Amplicon sequence variants (ASVs) were clustered into 14 co-abundant groups (CAGs) as potential functional groups that may respond to the intervention. The CAGs predominantly comprised of Bifidobacterium and Lactobacillus were more enriched, while the CAGs predominantly comprised of Bacteroides vulgatus , Alistipes , Blautia , Lachnospira , and Roseburia were more inhibited in the A group than in W group. Moreover, the CAGs enriched in the A group had a stronger negative correlation with the luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio, testosterone, homeostasis model assessment-insulin resistance (HOMA-IR), α-1-acid glycoprotein (α-AGP), and leptin, and positive correlation with adiponectin and spexin, while the CAGs inhibited showed an opposite trend. Conclusions High-fiber diet could alleviate the chronic metabolic inflammation, reproductive function, and brain–gut peptides secretion of patients with PCOS, and high-fiber diet combined with acarbose could better improve the PCOS clinical phenotypes. The remodeling of gut microbiota by our intervention may play an important role in these improvements. Clinical Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=4500 , ChiCTR-TRC-14005075
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In women with PCOS, high intake of fiber had a notable impact on increasing hormone levels and increasing the number of eggs.
“In a study conducted by Wang et al. (2022), which included only women suffering from PCOS, it was discovered that the high intake of fiber had a notable impact on the increase of the hormone and the increase in the number of eggs.”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [126]
The Results section (Improvement of Clinical Parameters; page not provided) reports that the LH/FSH ratio, testosterone, and number of immature follicles decreased in the high-fiber-plus-acarbose group; immature follicles did not change in the high-fiber-only group. Testosterone increased at week 12 in the high-fiber-only group, but the paper does not report an increase in the number of eggs. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIn women with PCOS, high intake of fiber had a notable impact on increasing hormone levels and increasing the number of eggs.
“In a study conducted by Wang et al. (2022), which included only women suffering from PCOS, it was discovered that the high intake of fiber had a notable impact on the increase of the hormone and the increase in the number of eggs.”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as Wang et al. (2022)
The Results section (Improvement of Clinical Parameters; page unavailable) reports a decrease in the LH/FSH ratio and testosterone in the high-fiber-plus-acarbose group, not a general increase in hormone levels. It also reports that immature follicle counts decreased in that group and did not change in the high-fiber-only group; it does not report an increase in the number of eggs. Testosterone did increase at week 12 in the high-fiber-only group, but that isolated finding does not support the claim as stated. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe mechanism for fiber's effect on hormones and eggs is related mainly to fiber's effect on gut microbiota, which regulates hormones and fights inflammation.
“The mechanism for this was related mainly to the effect of fiber on gut microbiota, which tends to regulate the hormones and fight against inflammation [126].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [126]
The Discussion (page unavailable) reports that the high-fiber intervention changed gut microbiota and that bacterial groups correlated with hormone levels and inflammatory factors. It suggests gut microbiota may play an important role in alleviating PCOS, but does not establish that this is the main mechanism or that the microbiota changes caused the hormonal and inflammatory effects. (LLM, conf=0.85)
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- Authors
- Wang, X., Xu, T., Liu, R., Wu, G., Gu, L., Zhang, Y., Zhang, F., Fu, H., Ling, Y., Wei, X., Luo, Y., Shen, J., Zhao, L., Peng, Y., Zhang, C., & Ding, X.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Zhang, Chenhong
- Ding, Xiaoying
- ORCID
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2022-02-02
- Volume
- 12
- Pages
- 806331-806331
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC8847200
- OpenAlex
- W4210493890
- Cited by
- 42
- References
- 63
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 11 · 2023: 10 · 2022: 4
- FWCI
- 7.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Natural Science Foundation of China
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- polycystic ovary syndrome, high-fiber diet, acarbose, gut microbiota, PCOS phenotypes, hyperandrogenism, insulin resistance, brain-gut peptides, metabolic inflammation, Bifidobacterium, Lactobacillus, luteinizing hormone/follicle-stimulating hormone ratio, adiponectin
- MeSH terms
- Gastrointestinal Microbiome, Female, Humans, Phenotype, Polycystic Ovary Syndrome, Acarbose, Dysbiosis
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