APLN and polycystic ovary syndrome: Thus, changes inintestinal microbiota with symbiotic play an importantrole in reducing apelin levels in PCOS patients (38).Karimi et al. (20) reported a significant decrease in serumapelin levels in women with PCOS following synbioticsupplementation from 27 ± 21 nmol/l at baseline to 14.4± 4.5 nmol/l at the end of study.