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益生菌与安慰剂和二甲双胍比较:多囊卵巢综合征的益生菌饮食干预 - 一项随机对照试验。

Probiotic vs. placebo and metformin: probiotic dietary intervention in polycystic ovary syndrome - A randomized controlled trial.

机构信息

Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Center for Medical Biomarker Research CBmed, Graz, Austria.

出版信息

BMC Endocr Disord. 2023 Apr 17;23(1):82. doi: 10.1186/s12902-023-01294-6.

Abstract

BACKGROUND

Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder with a variety of symptoms. Current treatment options include the contraceptive pill as well as metformin, however both treatments are limited to specific symptoms and have common side effects.

METHODS

This phase IV study is a monocentric, double blinded randomized clinical trial comparing the effects of six months of probiotic intervention to a placebo, with an additional open-label metformin arm as a positive control in a total of 180 participants with PCOS. The first of three visits is the screening visit, where inclusion/exclusion criteria are assessed. At the first visit, they are randomised into one of the three treatment arms equally and receive their study medication. After six months, all assessments from the first two visits are repeated. The primary endpoint is the change in free testosterone levels after the intervention, while secondary endpoints include changes in hormonal and metabolic parameters associated with PCOS as well as the gut microbial composition and diversity after intervention.

DISCUSSION

Based on new insights into the role of the gut microbiome in PCOS development, this study is exploring the potential of using probiotics to treat women with PCOS symptoms. If successful, this new therapy approach could open a new realm of possibilities for treating PCOS. To our knowledge, this is the first study comparing probiotic intervention with not only placebo treatment, but also metformin. This study has been approved by the ethics committee of the Medical University of Graz (EC number 32-230 ex 19/20).

REGISTRATION

EudraCT number: 2020-000228-20.

CLINICALTRIALS

gov identifier: NCT04593459.

PROTOCOL VERSION

Version 1.5 dated 29th November 2021.

摘要

背景

多囊卵巢综合征(PCOS)是一种非常常见的内分泌疾病,有多种症状。目前的治疗选择包括避孕药和二甲双胍,但这两种治疗方法都仅限于特定的症状,并且有常见的副作用。

方法

这是一项为期四个阶段的研究,是一项单中心、双盲随机临床试验,比较了六个月的益生菌干预与安慰剂的效果,以及作为阳性对照的二甲双胍开放标签手臂,共有 180 名 PCOS 患者参与。三次就诊中的第一次是筛选就诊,评估纳入/排除标准。在第一次就诊时,他们被平均随机分配到三个治疗组之一,并接受他们的研究药物。六个月后,重复前两次就诊的所有评估。主要终点是干预后游离睾酮水平的变化,次要终点包括与 PCOS 相关的激素和代谢参数的变化,以及干预后肠道微生物组成和多样性的变化。

讨论

基于对肠道微生物组在 PCOS 发展中的作用的新认识,本研究正在探索使用益生菌治疗有 PCOS 症状的女性的潜力。如果成功,这种新的治疗方法可能为治疗 PCOS 开辟一个新的领域。据我们所知,这是第一项比较益生菌干预与安慰剂治疗,以及二甲双胍的研究。本研究已获得格拉茨医科大学伦理委员会的批准(EC 编号 32-230 ex 19/20)。

注册

EudraCT 编号:2020-000228-20。

临床试验

gov 标识符:NCT04593459。

方案版本

2021 年 11 月 29 日第 1.5 版。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e43d/10108545/b11eaba60215/12902_2023_1294_Fig1_HTML.jpg

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