Limitations
A random forest model was conducted to classify PCOS, which showed the high accuracy of bacteria biomarkers for PCOS patients in Ji Nan (AUC=0.8), which indicated the significant association between PCOS and aberrant VMB. The ability of our model to distinguish PCOS has not been verified in other populations.
We excluded clinical symptoms, such as abnormal leucorrhea, pruritus vulva, and vaginal congestion at the time of sampling. Only asymptomatic case-control differences were observed and the VMB difference between symptomatic PCOS and controls was not yet determined. Therefore, we lack studies on symptomatic PCOS patients.