The relationship between intestinal flora and androgen level, glucose and lipid metabolism, inflammatory response and reproductive hormones: a systematic review and meta-analysis.

Abstract

Purpose: This meta-analysis of randomized controlled trials evaluated the effects of changes in gut microbiota on androgen levels, glucose and lipid metabolism, chronic inflammation, and reproductive hormones,in order to provide practical evidence for the treatment of the above pathological changes from the perspective of intestinal flora.

Methods: RCTs were searched on Embase, PubMed, and Web of Science, China Science Journal Database, Chinese National Knowledge Infrastructure, and Wanfang Data until March 2023.Using RevMan 5.4 software, meta-analysis was performed on the changes of androgen level, glucose and lipid metabolism, chronic inflammation, and reproductive hormone after intestinal flora changed.

Results: 1144 patients from 21 studies were included in the analysis. Methodological quality varies across studies.We found that changes in gut microbiota can significantly improve glucose metabolism and lower fasting blood glucose levels[(MD): − 0.72 (- 1.22, −0.21), p < 0.01], Fasting insulin levels [(MD:-1.71 (- 2.60, − 0.83), p < 0.01)], homeostasis model assessment-insulin resistance [(MD: − 0.96 (- 1.72, − 0.21), p = 0.01)]. C-reactive protein [MD: − 0.42 (- 0.73,- 0.10), p = 0.009], Tumor Necrosis Factor α, [MD: −0.85 (−1.19, −0.51), p < 0.01]. However, compared with the control group, there were no significant changes in androgen level, lipid metabolism level and reproductive hormones in the observation group. It still remains to confirm the effects of changes in gut bacteria on androgen levels, lipid metabolism level and reproductive hormone.

Conclusion: Improving intestinal flora can reduce the glycemic index and pro-inflammatory mediator of patients with relevant pathological manifestations. However, there is still insufficient clinical evidence to confirm the effects of changes in gut bacteria on androgen levels, lipid metabolism and reproductive hormones, and relevant studies need to be explored in more long-term trials.

Clinical trial number: Not applicable.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12902-025-02153-2.

Keywords: Androgen; Glucose and lipid metabolism; Inflammatory response; Intestinal flora; Meta-analysis; Reproductive hormones.