Enhanced Metabolic and Endocrine Outcomes with Probiotics as an Adjunct to Metformin and Calorie Restriction in Obese Patients with Polycystic Ovary Syndrome
DOI:
https://doi.org/10.70749/ijbr.v4i5.3088Keywords:
Polycystic Ovary Syndrome; Probiotics; Metformin; Calorie Restriction; Insulin Resistance; Gut MicrobiotaAbstract
Objective: To evaluate the clinical efficacy of probiotics as an adjunct therapy to metformin and calorie restriction in managing endocrine, metabolic, and gut microbiota profiles in obese patients with Polycystic Ovary Syndrome (PCOS). Methods: The clinical data for the treatment of 148 obese patients with PCOS treated in the 73rd Group Army Hospital from February 2025 to January 2026 was collected and analyzed. Patients were divided into two groups based on their recorded treatment with metformin: Metformin Group (n = 72): received conventional metformin treatment with a calorie restricted diet; Combined Group (n = 76): received probiotic treatment in addition to the metformin and calorie restricted diet treatment regimen. Homeostatic model assessment of insulin resistance (HOMA-IR), fasting blood glucose (FPG), body mass index (BMI) and gut microbiota composition were assessed and compared at baseline and after 12 weeks of treatment. Results: In both groups, BMI, FPG and HOMA-IR values were found to be significantly decreased after the treatment than prior to it (P<0.05). But the Combined Group actually had much more significant decreases in HOMA-IR and FPG compared with the Metformin Group (P < 0.05). Nevertheless, the serum total testosterone/follicle stimulating hormone (TT/FSH) ratio and serum luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio showed further substantial reductions in the Combined Group (both P less than 0.05). Additionally, the combined group had a meaningful improvement in good bacteria Bifidobacterium and Lactobacillus, and a significant decrease in the bad bacteria Bacteroides level when compared with the Metformin Group (p < 0.05). Conclusion: In conclusion, calorie restriction and metformin combined with the addition of a probiotic showed significant effects on insulin sensitivity, reducing hyperandrogenism and restoring the eubiosis of the gut microbiota in obese PCOS patients. This is a triple therapy that provides better metabolic and endocrine results than standard therapy with metformin and dietary changes.
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