Exercise training in polycystic ovarian syndrome enhances flow-mediated dilation in the absence of changes in fatness.
BACKGROUND
Polycystic ovarian syndrome (PCOS) is associated with an adverse cardiovascular disease (CVD) profile. A surrogate marker for CVD risk is endothelial dysfunction. Limited studies exist examining the cardiovascular and metabolic effects of exercise in PCOS and specifically its impact on endothelial function. Therefore, the aim of the current study was to investigate the impact of exercise on endothelial function, in parallel with body composition, insulin resistance, and cardiopulmonary fitness in PCOS.


METHODS
Ten women with PCOS (27 yr, 95% confidence interval [CI] = 23-32; 31 kg·m⁻², 95% CI = 28-34) completed a 16-wk exercise (EX) program, and seven women with PCOS (29 yr, 95% CI = 24-35; 35 kg·m⁻², 95% CI = 31-40) undertook conventional care (CC) following lifestyle advice. Brachial artery endothelial function was assessed pre- and postintervention using flow-mediated dilation adjusted for variability in baseline diameter. Visceral and abdominal subcutaneous adipose tissue was assessed using whole-body magnetic resonance imaging and ¹H magnetic resonance spectroscopy quantified liver fat. Cardiorespiratory fitness, glycemic control, hormone, and lipid profiles were also assessed. Data were analyzed using covariate-controlled generalized estimating equations.


RESULTS
At follow-up, EX improved flow-mediated dilation by 3.6% (95% CI = 0.5-6.7, P = 0.03) more than CC. There was a parallel improvement in cardiorespiratory fitness of 4.7 mL·kg⁻¹·min⁻¹ (95% CI = 1.4-7.9, P < 0.001) with EX versus CC. These changes were not explained by changes in visceral adipose tissue, subcutaneous adipose tissue, liver fat or insulin resistance.


CONCLUSIONS
Supervised exercise in women with PCOS improves endothelial function, an adaptation associated with reduced CVD risk. This change occurs independent of changes in body weight or composition. The success of public health interventions in this patient group should not be solely judged by weight loss.
1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM; 2Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UNITED KINGDOM; 3School of Sports Science, Exercise and Health, University of Western Australia, Crawley, Western Australia, AUSTRALIA; 4Department of Gynaecology, Liverpool Women's Hospital, Liverpool, UNITED KINGDOM; and, 5Magnetic Resonance and Image Analysis Research Centre and Department of Musculoskeletal Biology, University of Liverpool, UNITED KINGDOM.
Victoria S
VS
Sprung
Daniel J
DJ
Cuthbertson
Christopher J A
CJ
Pugh
Nabil
N
Aziz
Graham J
GJ
Kemp
Christina
C
Daousi
Daniel J
DJ
Green
Nigel Timothy
NT
Cable
Helen
H
Jones
D000328:Adult; D001823:Body Composition; D001916:Brachial Artery / Q000502:physiology; D016001:Confidence Intervals; D004730:Endothelium, Vascular / Q000502:physiology*; D004739:England; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D010809:Physical Fitness / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D050151:Subcutaneous Fat