Interlinked Microbiota-Metabolite-Epigenome Dynamics in the Gut-Heart-Ovary Axis: New Perspectives on Cardiometabolic Risk in Polycystic Ovary Syndrome.

Beyond reproductive dysfunction, polycystic ovarian syndrome (PCOS) is a complex endocrine condition that significantly raises metabolic and cardiovascular morbidity in PCOSaffected individuals. There is growing evidence that the gut microbiota plays a vital role in the pathogenesis of PCOS and the cardiometabolic problems associated with it. This review examined the novel premise of the gut-heart-ovary axis, emphasising how gut microbial dysbiosis in PCOS interferes with critical processes related to inflammation, insulin resistance, lipid metabolism, and endothelial function, ultimately leading to problems with the heart. It has been demonstrated that changes in microbial-derived metabolites, such as bile acids, trimethylamine-N-oxide (TMAO), and short-chain fatty acids (SCFAs), damage the intestinal barrier, cause systemic inflammation, and worsen vascular dysfunction, thereby aggravating mechanisms underlying the development of cardiovascular disease. Additionally, a recent study indicates that gut dysbiosis and cardiovascular disease in PCOS may be mechanistically linked through microbiota-microRNA interactions and epigenetic changes brought on by gut-derived signals. This study emphasises the need for comprehensive approaches to decipher the intricate interactions underlying PCOS and its cardiometabolic aftereffects by clarifying the triangle crosstalk among the gut, heart, and ovary. Additionally, it finds new genetic targets for therapeutic intervention with implications for cardiovascular and reproductive health, especially in the field of microbiota-centered targeted therapy.