(21-02-11) Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndr

Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome.

Hutchison SK, Stepto NK, Harrison CL, Moran LJ, Strauss BJ, Teede HJ.

The Jean Hailes Clinical Research Unit, School of Public Health, Monash
University, Clayton, Victoria, Australia.
Abstract
CONTEXT: Polycystic ovary syndrome (PCOS) is an insulin-resistant (IR) state.
Visceral fat (VF) is independently associated with IR.

OBJECTIVES: The objectives of the study were to explore mechanisms
underpinning IR by assessing the effect of exercise training on IR and body
composition in overweight PCOS and non-PCOS women.

DESIGN: This was a prospective exercise intervention study.

SETTING AND PARTICIPANTS: The study was conducted at an academic medical
center. Participants included 20 overweight PCOS and 14 overweight non-PCOS
women.

INTERVENTION: The intervention included 12 wk of intensified aerobic exercise
(3 h/wk).

MAIN OUTCOME MEASURES: IR on euglycemic hyperinsulinemic clamp, body
composition including abdominal visceral and sc fat distribution by computer
tomography and lipids was measured.

RESULTS: PCOS subjects were more IR (P = 0.02) and had more VF (P = 0.04 age
adjusted) than non-PCOS women. In PCOS women, IR correlated with VF (r = -0.78,
P < 0.01). With exercise training, both groups maintained weight but within
PCOS, VF (-12.0 cm(2), P = 0.03) and within non-PCOS abdominal sc fat (-40.2 cm
(2), P = 0.02) decreased. Despite exercise-induced improvement in IR within
PCOS (+27.9 mg ? m(-2) ? min(-1), P = 0.03), no relationship with decreased VF
(r = -0.08, P = 0.84) and no differential changes in IR and VF between groups
were noted. Triglycerides decreased within PCOS (-0.27 mmol/liter, P = 0.02)
and decreased differentially between groups (P < 0.01).

CONCLUSIONS: Higher IR was related to increased VF in PCOS, suggesting an
etiological role for VF in intrinsic IR in PCOS; however, changes with exercise
intervention did not support a causal relationship. Triglycerides were
modulated more by exercise training in PCOS than non-PCOS women. Within-group
exercise-induced reductions in cardiometabolic risk factors including IR,
triglycerides, and VF in PCOS were observed without significant weight loss and
if confirmed in future controlled trials, suggest weight loss should not be the
sole focus of exercise programs.


Sources:
J Clin Endocrinol Metab. 2011 Jan;96(1):E48-56. Epub 2010 Oct 6.
PMID: 20926534 [PubMed - indexed for MEDLINE]

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