# Resistant starch treatment of polycystic ovary syndrome: impact on cardiometabolic dysfunction and the gut microbiome

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $522,579

## Abstract

Hyperandrogenic women with polycystic ovary syndrome (PCOS) have a high prevalence of cardiovascular
disease (CVD) risk factors including obesity, insulin resistance, hypertension, and dyslipidemia that result in an
increased risk of hypertensive disorders of pregnancy, type 2 diabetes and CVD events. Surveys also show
significant dissatisfaction amongst women with PCOS regarding long-term counselling and management of their
cardiometabolic risk. Although lifestyle interventions and oral contraceptive pills (OCPs) are recommended as
first-line treatment for PCOS, there are no dietary or pharmacological recommendations for prevention of CVD
risk in PCOS, indicating a considerable knowledge gap. Resistant starch, a type of dietary fiber, may offer a
promising solution with significant improvements in CVD risk factors and CVD events in the general population.
In addition, resistant starch use has been associated with increased abundance of short chain fatty acids (SCFA)-
producing gut bacteria, such as Bifidobacteria, and SCFAs in the general population. Recent studies also
showed that Bifidobacteria and SCFAs are decreased in women with PCOS, and that exposure to a healthy gut
microbiome via cohousing or fecal microbiome transplantation improved cardiometabolic parameters in PCOS
rodent models. These studies indicate that modulation of the gut microbiome may be a potential novel treatment
target for cardiometabolic dysregulation in PCOS. While increased dietary fiber improves cardiometabolic and
gut health in the general population, the impact of resistant starch supplementation on cardiometabolic
parameters or the gut microbiome in women with PCOS treated with OCPs has not been investigated. Use of
OCPs especially in women with overweight /obesity is associated with dyslipidemia, hypertension and glucose
dysregulation. We will test the hypothesis that treatment with resistant starch in combination with OCPs
results in improvement in cardiometabolic parameters, as well as specific gut microbes and metabolites,
such as Bifidobacteria and SCFAs compared to OCPs alone. In Aim 1, we will enroll 100 women with
hyperandrogenic PCOS and overweight/obesity in a double-blind placebo-controlled 2-arm RCT for 12 weeks:
Arm A) OCP + resistant starch and Arm B) OCP + maltodextrin (resistant starch placebo). We will investigate
how resistant starch treatment in combination with OCPs improves individual cardiometabolic parameters,
markers of insulin resistance, glucoregulatory status and inflammation compared to OCPs alone. In Aim 2, we
will use metagenomics and metabolomics to determine how OCPs + resistant starch impact abundances of
Bifidobacteria and other gut microbes, microbial genes and SCFAs compared to OCPs alone and if changes in
the gut microbiome correlate with changes in specific cardiometabolic parameters. Results from this proposal
will provide support for the implementation of a low-cost, nutritional therapy to counter negative cardiometabolic
eff...

## Key facts

- **NIH application ID:** 10871477
- **Project number:** 1R01HL173772-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** ANUJA DOKRAS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $522,579
- **Award type:** 1
- **Project period:** 2024-09-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10871477

## Citation

> US National Institutes of Health, RePORTER application 10871477, Resistant starch treatment of polycystic ovary syndrome: impact on cardiometabolic dysfunction and the gut microbiome (1R01HL173772-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10871477. Licensed CC0.

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