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Research indicates that patients with PCOS exhibit lower levels of α- and β-diversity in their gut microbiota compared to healthy individuals ( 2.2 Mechanism of gut microbiota affecting PCOS 2.2.1 Hyperandrogenism Hyperandrogenemia (HA) is a key pathological feature of polycystic ovary syndrome (PCOS), leading to various clinical manifestations such as hirsutism, acne, ovulatory dysfunction, and impaired follicular development ( 2.2.2 Insulin resistance Insulin resistance (IR) is a common endocrine feature in PCOS

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Additionally, endothelin 1, a vasoconstrictor peptide synthesized by the endothelium, plays a crucial role in maintaining vascular tone in healthy individuals