title: Vigorous exercise is associated with superior metabolic profiles in polycystic ovary syndrome independent of total exercise expenditure.
abstract: OBJECTIVE
  To characterize metabolic features of women with polycystic ovary syndrome (PCOS) by exercise behavior and determine relative health benefits of different exercise intensities.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary academic institution.
  
  
  METHODS
  Three hundred and twenty-six women aged 14-52 years-old with PCOS by Rotterdam criteria examined between 2006 and 2013.
  
  
  METHODS
  International Physical Activity Questionnaire (IPAQ) administered to classify patients into three groups based on Department of Health and Human Services (DHHS) Guidelines of vigorous, moderate, and inactive, along with physical examination and serum testing.
  
  
  METHODS
  Blood pressure, body mass index (BMI), waist circumference, fasting lipids, fasting glucose and insulin, 2-hour 75-gram oral glucose tolerance, homeostatic model assessment of insulin resistance (HOMA-IR).
  
  
  RESULTS
  The DHHS guidelines for adequate physical activity were met by 182 (56%) women. Compared with moderate exercisers and inactive women, the vigorous exercisers had lower BMI and lower HOMA-IR; higher levels of high-density lipoprotein cholesterol and sex hormone-binding globulin; and a reduced prevalence of the metabolic syndrome. In a multivariate logistic regression analysis controlling for age, BMI, and total energy expenditure, every hour of vigorous exercise reduced a patient's odds of metabolic syndrome by 22% (odds ratio 0.78; 95% confidence interval, 0.62, 0.99).
  
  
  CONCLUSIONS
  Women with PCOS who met DHHS guidelines for exercise demonstrated superior metabolic health parameters. Vigorous but not moderate activity is associated with reduced odds of the metabolic syndrome, independent of age, BMI, and total energy expenditure. PCOS patients should be encouraged to meet activity guidelines via vigorous physical activity.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California. Electronic address: greenwoode@obgyn.ucsf.edu.
authors.forename: Eleni A
authors.initials: EA
authors.lastname: Greenwood
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California.
authors.forename: Martha W
authors.initials: MW
authors.lastname: Noel
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California.
authors.forename: Chia-Ning
authors.initials: CN
authors.lastname: Kao
authors.affiliation: Department of Dermatology, University of California at San Francisco, San Francisco, California.
authors.forename: Kanade
authors.initials: K
authors.lastname: Shinkai
authors.affiliation: Department of Psychiatry, University of California at San Francisco, San Francisco, California.
authors.forename: Lauri A
authors.initials: LA
authors.lastname: Pasch
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California.
authors.forename: Marcelle I
authors.initials: MI
authors.lastname: Cedars
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California.
authors.forename: Heather G
authors.initials: HG
authors.lastname: Huddleston
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D065840:Protective Factors; D012307:Risk Factors; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids
keywords: Exercise intensity; insulin resistance; metabolic syndrome; polycystic ovary syndrome